HF 90

5th Engrossment - 91st Legislature (2019 - 2020) Posted on 05/10/2019 04:39pm

A bill for an act
relating to health; establishing consumer protections for residents of assisted living
establishments; prohibiting deceptive marketing and business practices; establishing
provisions for independent senior living facilities; establishing an assisted living
establishment license; changing the name for Board of Examiners for Nursing
Home Administrators; imposing fees; establishing a health services executive
license; making certain conforming changes; providing penalties; granting
rulemaking authority; requiring reports; appropriating money; amending Minnesota
Statutes 2018, sections 144.051, subdivisions 4, 5, 6; 144.057, subdivision 1;
144.122; 144A.04, subdivision 5; 144A.19, subdivision 1; 144A.20, subdivision
1, by adding subdivisions; 144A.21; 144A.23; 144A.24; 144A.251; 144A.2511;
144A.26; 144A.44, subdivision 1; 144A.471, subdivisions 7, 9; 144A.472,
subdivision 7; 144A.474, subdivisions 9, 11; 144A.475, subdivisions 3b, 5;
144A.476, subdivision 1; 144A.4791, subdivision 10; 144A.4799; 256.9741,
subdivision 1; 256I.03, subdivision 15; 256I.04, subdivision 2a; 325F.72,
subdivisions 1, 2, 4; 626.5572, subdivision 6; proposing coding for new law in
Minnesota Statutes, chapters 144; 144A; 144G; proposing coding for new law as
Minnesota Statutes, chapters 144I; 144J; 144K; repealing Minnesota Statutes 2018,
sections 144A.441; 144A.442; 144A.472, subdivision 4; 144D.01; 144D.015;
144D.02; 144D.025; 144D.03; 144D.04; 144D.045; 144D.05; 144D.06; 144D.065;
144D.066; 144D.07; 144D.08; 144D.09; 144D.10; 144D.11; 144G.01; 144G.02;
144G.03; 144G.04; 144G.05; 144G.06.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

RESIDENT RIGHTS AND CONSUMER PROTECTIONS

Section 1.

new text begin [144.6512] RETALIATION IN NURSING HOMES PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For the purposes of this section:
new text end

new text begin (1) "nursing home" means a facility licensed as a nursing home under chapter 144A;
and
new text end

new text begin (2) "resident" means a person residing in a nursing home.
new text end

new text begin Subd. 2. new text end

new text begin Retaliation prohibited. new text end

new text begin A nursing home or agent of the nursing home may not
retaliate against a resident or employee if the resident, employee, or any person acting on
behalf of the resident:
new text end

new text begin (1) files a complaint or grievance, makes an inquiry, or asserts any right;
new text end

new text begin (2) indicates an intention to file a complaint or grievance, make an inquiry, or assert any
right;
new text end

new text begin (3) files or indicates an intention to file a maltreatment report, whether mandatory or
voluntary, under section 626.557;
new text end

new text begin (4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
problems or concerns to the administrator or manager of the nursing home, the Office of
Ombudsman for Long-Term Care, a regulatory or other government agency, or a legal or
advocacy organization;
new text end

new text begin (5) advocates or seeks advocacy assistance for necessary or improved care or services
or enforcement of rights under this section or other law;
new text end

new text begin (6) takes or indicates an intention to take civil action;
new text end

new text begin (7) participates or indicates an intention to participate in any investigation or
administrative or judicial proceeding;
new text end

new text begin (8) contracts or indicates an intention to contract to receive services from a service
provider of the resident's choice other than the nursing home; or
new text end

new text begin (9) places or indicates an intention to place a camera or electronic monitoring device in
the resident's private space as provided under section 144J.05.
new text end

new text begin Subd. 3. new text end

new text begin Retaliation against a resident. new text end

new text begin For purposes of this section, to retaliate against
a resident includes but is not limited to any of the following actions taken or threatened by
a nursing home or an agent of the nursing home against a resident, or any person with a
familial, personal, legal, or professional relationship with the resident:
new text end

new text begin (1) the discharge, eviction, transfer, or termination of services;
new text end

new text begin (2) the imposition of discipline, punishment, or a sanction or penalty;
new text end

new text begin (3) any form of discrimination;
new text end

new text begin (4) restriction or prohibition of access:
new text end

new text begin (i) of the resident to the nursing home or visitors; or
new text end

new text begin (ii) to the resident by a family member or a person with a personal, legal, or professional
relationship with the resident;
new text end

new text begin (5) the imposition of involuntary seclusion or withholding food, care, or services;
new text end

new text begin (6) restriction of any of the rights granted to residents under state or federal law;
new text end

new text begin (7) restriction or reduction of access to or use of amenities, care, services, privileges, or
living arrangements;
new text end

new text begin (8) an arbitrary increase in charges or fees;
new text end

new text begin (9) removing, tampering with, or deprivation of technology, communication, or electronic
monitoring devices; or
new text end

new text begin (10) any oral or written communication of false information about a person advocating
on behalf of the resident.
new text end

new text begin Subd. 4. new text end

new text begin Retaliation against an employee. new text end

new text begin For purposes of this section, to retaliate
against an employee includes but is not limited to any of the following actions taken or
threatened by the nursing home or an agent of the nursing home against an employee:
new text end

new text begin (1) discharge or transfer;
new text end

new text begin (2) demotion or refusal to promote;
new text end

new text begin (3) reduction in compensation, benefits, or privileges;
new text end

new text begin (4) the unwarranted imposition of discipline, punishment, or a sanction or penalty; or
new text end

new text begin (5) any form of discrimination.
new text end

new text begin Subd. 5. new text end

new text begin Rebuttable presumption of retaliation. new text end

new text begin (a) Except as provided in paragraphs
(b), (c), and (d), there is a rebuttable presumption that any action described in subdivision
3 or 4 and taken within 90 days of an initial action described in subdivision 2 is retaliatory.
new text end

new text begin (b) The presumption does not apply to actions described in subdivision 3, clause (4), if
a good faith report of maltreatment pursuant to section 626.557 is made by the nursing home
or agent of the nursing home against the visitor, family member, or other person with a
personal, legal, or professional relationship who is subject to the restriction or prohibition
of access.
new text end

new text begin (c) The presumption does not apply to any oral or written communication described in
subdivision 3, clause (10), that is associated with a good faith report of maltreatment pursuant
to section 626.557 made by the nursing home or agent of the nursing home against the
person advocating on behalf of the resident.
new text end

new text begin (d) The presumption does not apply to a termination of a contract of admission, as that
term is defined under section 144.6501, subdivision 1, for a reason permitted under state
or federal law.
new text end

new text begin Subd. 6. new text end

new text begin Remedy. new text end

new text begin A resident who meets the criteria under section 325F.71, subdivision
1, has a cause of action under section 325F.71, subdivision 4, for the violation of this section,
unless the resident otherwise has a cause of action under section 626.557, subdivision 17.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 2.

new text begin [144G.07] RETALIATION PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For the purposes of this section and section 144G.08:
new text end

new text begin (1) "facility" means a housing with services establishment registered under section
144D.02 and operating under title protection under this chapter; and
new text end

new text begin (2) "resident" means a resident of a facility.
new text end

new text begin Subd. 2. new text end

new text begin Retaliation prohibited. new text end

new text begin A facility or agent of the facility may not retaliate
against a resident or employee if the resident, employee, or any person on behalf of the
resident:
new text end

new text begin (1) files a complaint or grievance, makes an inquiry, or asserts any right;
new text end

new text begin (2) indicates an intention to file a complaint or grievance, make an inquiry, or assert any
right;
new text end

new text begin (3) files or indicates an intention to file a maltreatment report, whether mandatory or
voluntary, under section 626.557;
new text end

new text begin (4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
problems or concerns to the administrator or manager of the facility, the Office of
Ombudsman for Long-Term Care, a regulatory or other government agency, or a legal or
advocacy organization;
new text end

new text begin (5) advocates or seeks advocacy assistance for necessary or improved care or services
or enforcement of rights under this section or other law;
new text end

new text begin (6) takes or indicates an intention to take civil action;
new text end

new text begin (7) participates or indicates an intention to participate in any investigation or
administrative or judicial proceeding;
new text end

new text begin (8) contracts or indicates an intention to contract to receive services from a service
provider of the resident's choice other than the facility; or
new text end

new text begin (9) places or indicates an intention to place a camera or electronic monitoring device in
the resident's private space as provided under section 144J.05.
new text end

new text begin Subd. 3. new text end

new text begin Retaliation against a resident. new text end

new text begin For purposes of this section, to retaliate against
a resident includes but is not limited to any of the following actions taken or threatened by
a facility or an agent of the facility against a resident, or any person with a familial, personal,
legal, or professional relationship with the resident:
new text end

new text begin (1) the discharge, eviction, transfer, or termination of services;
new text end

new text begin (2) the imposition of discipline, punishment, or a sanction or penalty;
new text end

new text begin (3) any form of discrimination;
new text end

new text begin (4) restriction or prohibition of access:
new text end

new text begin (i) of the resident to the facility or visitors; or
new text end

new text begin (ii) to the resident by a family member or a person with a personal, legal, or professional
relationship with the resident;
new text end

new text begin (5) the imposition of involuntary seclusion or withholding food, care, or services;
new text end

new text begin (6) restriction of any of the rights granted to residents under state or federal law;
new text end

new text begin (7) restriction or reduction of access to or use of amenities, care, services, privileges, or
living arrangements;
new text end

new text begin (8) an arbitrary increase in charges or fees;
new text end

new text begin (9) removing, tampering with, or deprivation of technology, communication, or electronic
monitoring devices; or
new text end

new text begin (10) any oral or written communication of false information about a person advocating
on behalf of the resident.
new text end

new text begin Subd. 4. new text end

new text begin Retaliation against an employee. new text end

new text begin For purposes of this section, to retaliate
against an employee includes but is not limited to any of the following actions taken or
threatened by the facility or an agent of the facility against an employee:
new text end

new text begin (1) discharge or transfer;
new text end

new text begin (2) demotion or refusal to promote;
new text end

new text begin (3) reduction in compensation, benefits, or privileges;
new text end

new text begin (4) the unwarranted imposition of discipline, punishment, or a sanction or penalty; or
new text end

new text begin (5) any form of discrimination.
new text end

new text begin Subd. 5. new text end

new text begin Rebuttable presumption of retaliation. new text end

new text begin (a) Except as provided in paragraphs
(b), (c), and (d), there is a rebuttable presumption that any action described in subdivision
3 or 4 and taken within 90 days of an initial action described in subdivision 2 is retaliatory.
new text end

new text begin (b) The presumption does not apply to actions described in subdivision 3, clause (4), if
a good faith report of maltreatment pursuant to section 626.557 is made by the facility or
agent of the facility against the visitor, family member, or other person with a personal,
legal, or professional relationship who is subject to the restriction or prohibition of access.
new text end

new text begin (c) The presumption does not apply to any oral or written communication described in
subdivision 3, clause (10), that is associated with a good faith report of maltreatment pursuant
to section 626.557 made by the facility or agent of the facility against the person advocating
on behalf of the resident.
new text end

new text begin (d) The presumption does not apply to a termination of a housing with services contract
for a reason permitted under state or federal law.
new text end

new text begin Subd. 6. new text end

new text begin Remedy. new text end

new text begin A resident who meets the criteria under section 325F.71, subdivision
1, has a cause of action under section 325F.71, subdivision 4, for the violation of this section,
unless the resident otherwise has a cause of action under section 626.557, subdivision 17.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019, and expires July 31,
2021.
new text end

Sec. 3.

new text begin [144G.08] DECEPTIVE MARKETING AND BUSINESS PRACTICES
PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Prohibitions. new text end

new text begin (a) No employee or agent of any facility may make any
false, fraudulent, deceptive, or misleading statements or representations or material omissions
in marketing, advertising, or any other description or representation of care or services.
new text end

new text begin (b) No housing with services contract as required under section 144D.04, subdivision
1, may include any provision that the facility knows or should know to be deceptive,
unlawful, or unenforceable under state or federal law, nor include any provision that requires
or implies a lesser standard of care or responsibility than is required by law.
new text end

new text begin (c) No facility may advertise or represent that the facility has a dementia care unit without
complying with disclosure requirements under section 325F.72 and all additional
requirements in chapter 144I and in rule.
new text end

new text begin Subd. 2. new text end

new text begin Remedies. new text end

new text begin (a) A violation of this section constitutes a violation of section
325F.69, subdivision 1. The attorney general or a county attorney may enforce this section
using the remedies in section 325F.70.
new text end

new text begin (b) A resident who meets the criteria under section 325F.71, subdivision 1, has a cause
of action under section 325F.71, subdivision 4, for the violation of this section, unless the
resident otherwise has a cause of action under section 626.557, subdivision 17.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019, and expires July 31,
2021.
new text end

Sec. 4.

new text begin [144J.01] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin For the purposes of this chapter, the following terms have
the meanings given them unless the context clearly indicates otherwise.
new text end

new text begin Subd. 2. new text end

new text begin Assisted living contract. new text end

new text begin "Assisted living contract" means the legal agreement
between a resident and an assisted living facility for housing and, if applicable, assisted
living services.
new text end

new text begin Subd. 3. new text end

new text begin Assisted living facility. new text end

new text begin "Assisted living facility" has the meaning given in
section 144I.01, subdivision 7.
new text end

new text begin Subd. 4. new text end

new text begin Assisted living facility with dementia care. new text end

new text begin "Assisted living facility with
dementia care" has the meaning given in section 144I.01, subdivision 8.
new text end

new text begin Subd. 5. new text end

new text begin Assisted living services. new text end

new text begin "Assisted living services" has the meaning given in
section 144I.01, subdivision 9.
new text end

new text begin Subd. 6. new text end

new text begin Attorney-in-fact. new text end

new text begin "Attorney-in-fact" means a person designated by a principal
to exercise the powers granted by a written and valid power of attorney under chapter 523.
new text end

new text begin Subd. 7. new text end

new text begin Conservator. new text end

new text begin "Conservator" means a court-appointed conservator acting in
accordance with the powers granted to the conservator under chapter 524.
new text end

new text begin Subd. 8. new text end

new text begin Designated representative. new text end

new text begin "Designated representative" means a person
designated in writing by the resident in an assisted living contract and identified in the
resident's records on file with the assisted living facility.
new text end

new text begin Subd. 9. new text end

new text begin Facility. new text end

new text begin "Facility" means an assisted living facility.
new text end

new text begin Subd. 10. new text end

new text begin Guardian. new text end

new text begin "Guardian" means a court-appointed guardian acting in accordance
with the powers granted to the guardian under chapter 524.
new text end

new text begin Subd. 11. new text end

new text begin Health care agent. new text end

new text begin "Health care agent" has the meaning given in section
145C.01, subdivision 2.
new text end

new text begin Subd. 12. new text end

new text begin Legal representative. new text end

new text begin "Legal representative" means one of the following in
the order of priority listed, to the extent the person may reasonably be identified and located:
new text end

new text begin (1) a guardian;
new text end

new text begin (2) a conservator;
new text end

new text begin (3) a health care agent; or
new text end

new text begin (4) an attorney-in-fact.
new text end

new text begin Subd. 13. new text end

new text begin Licensed health professional. new text end

new text begin "Licensed health professional" means:
new text end

new text begin (1) a physician licensed under chapter 147;
new text end

new text begin (2) an advanced practice registered nurse, as that term is defined in section 148.171,
subdivision 3;
new text end

new text begin (3) a licensed practical nurse, as that term is defined in section 148.171, subdivision 8;
or
new text end

new text begin (4) a registered nurse, as that term is defined in section 148.171, subdivision 20.
new text end

new text begin Subd. 14. new text end

new text begin Resident. new text end

new text begin "Resident" means a person living in an assisted living facility.
new text end

new text begin Subd. 15. new text end

new text begin Resident record. new text end

new text begin "Resident record" has the meaning given in section 144I.01,
subdivision 60.
new text end

new text begin Subd. 16. new text end

new text begin Service plan. new text end

new text begin "Service plan" has the meaning given in section 144I.01,
subdivision 63.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 5.

new text begin [144J.02] ASSISTED LIVING BILL OF RIGHTS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin This section applies to residents living in assisted living
facilities.
new text end

new text begin Subd. 2. new text end

new text begin Legislative intent. new text end

new text begin The rights established under this section for the benefit of
residents do not limit any other rights available under law. No facility may request or require
that any resident waive any of these rights at any time for any reason, including as a condition
of admission to the facility.
new text end

new text begin Subd. 3. new text end

new text begin Information about rights. new text end

new text begin Before receiving services, residents have the right
to be informed by the facility of the rights granted under this section and the recourse
residents have if rights are violated. The information must be in plain language and in terms
residents can understand. The facility must make reasonable accommodations for residents
who have communication disabilities and those who speak a language other than English.
new text end

new text begin Subd. 4. new text end

new text begin Appropriate care and services. new text end

new text begin (a) Residents have the right to care and assisted
living services that are appropriate based on the resident's needs and according to an
up-to-date service plan subject to accepted health care standards.
new text end

new text begin (b) Residents have the right to receive health care and other assisted living services with
continuity from people who are properly trained and competent to perform their duties and
in sufficient numbers to adequately provide the services agreed to in the assisted living
contract and the service plan.
new text end

new text begin Subd. 5. new text end

new text begin Refusal of care or services. new text end

new text begin Residents have the right to refuse care or assisted
living services and to be informed by the facility of the medical, health-related, or
psychological consequences of refusing care or services.
new text end

new text begin Subd. 6. new text end

new text begin Participation in care and service planning. new text end

new text begin Residents have the right to actively
participate in the planning, modification, and evaluation of their care and services. This
right includes:
new text end

new text begin (1) the opportunity to discuss care, services, treatment, and alternatives with the
appropriate caregivers;
new text end

new text begin (2) the right to include a family member or the resident's health care agent and designated
representative, or both; and
new text end

new text begin (3) the right to be told in advance of, and take an active part in decisions regarding, any
recommended changes in the service plan.
new text end

new text begin Subd. 7. new text end

new text begin Courteous treatment. new text end

new text begin Residents have the right to be treated with courtesy and
respect, and to have the resident's property treated with respect.
new text end

new text begin Subd. 8. new text end

new text begin Freedom from maltreatment. new text end

new text begin Residents have the right to be free from physical,
sexual, and emotional abuse; neglect; financial exploitation; and all forms of maltreatment
covered under the Vulnerable Adults Act.
new text end

new text begin Subd. 9. new text end

new text begin Right to come and go freely. new text end

new text begin Residents have the right to enter and leave the
facility as they choose. This right may be restricted only as allowed by other law and
consistent with a resident's service plan.
new text end

new text begin Subd. 10. new text end

new text begin Individual autonomy. new text end

new text begin Residents have the right to individual autonomy,
initiative, and independence in making life choices, including establishing a daily schedule
and choosing with whom to interact.
new text end

new text begin Subd. 11. new text end

new text begin Right to control resources. new text end

new text begin Residents have the right to control personal
resources.
new text end

new text begin Subd. 12. new text end

new text begin Visitors and social participation. new text end

new text begin (a) Residents have the right to meet with
or receive visits at any time by the resident's family, guardian, conservator, health care
agent, attorney, advocate, or religious or social work counselor, or any person of the resident's
choosing. This right may be restricted in certain circumstances if necessary for the resident's
health and safety and if documented in the resident's service plan.
new text end

new text begin (b) Residents have the right to engage in community life and in activities of their choice.
This includes the right to participate in commercial, religious, social, community, and
political activities without interference and at their discretion if the activities do not infringe
on the rights of other residents.
new text end

new text begin Subd. 13. new text end

new text begin Personal and treatment privacy. new text end

new text begin (a) Residents have the right to consideration
of their privacy, individuality, and cultural identity as related to their social, religious, and
psychological well-being. Staff must respect the privacy of a resident's space by knocking
on the door and seeking consent before entering, except in an emergency or where clearly
inadvisable or unless otherwise documented in the resident's service plan.
new text end

new text begin (b) Residents have the right to have and use a lockable door to the resident's unit. The
facility shall provide locks on the resident's unit. Only a staff member with a specific need
to enter the unit shall have keys. This right may be restricted in certain circumstances if
necessary for a resident's health and safety and documented in the resident's service plan.
new text end

new text begin (c) Residents have the right to respect and privacy regarding the resident's service plan.
Case discussion, consultation, examination, and treatment are confidential and must be
conducted discreetly. Privacy must be respected during toileting, bathing, and other activities
of personal hygiene, except as needed for resident safety or assistance.
new text end

new text begin Subd. 14. new text end

new text begin Communication privacy. new text end

new text begin (a) Residents have the right to communicate
privately with persons of their choice.
new text end

new text begin (b) If an assisted living facility is sending or receiving mail on behalf of residents, the
assisted living facility must do so without interference.
new text end

new text begin (c) Residents must be provided access to a telephone to make and receive calls.
new text end

new text begin Subd. 15. new text end

new text begin Confidentiality of records. new text end

new text begin (a) Residents have the right to have personal,
financial, health, and medical information kept private, to approve or refuse release of
information to any outside party, and to be advised of the assisted living facility's policies
and procedures regarding disclosure of the information. Residents must be notified when
personal records are requested by any outside party.
new text end

new text begin (b) Residents have the right to access their own records.
new text end

new text begin Subd. 16. new text end

new text begin Right to furnish and decorate. new text end

new text begin Residents have the right to furnish and decorate
the resident's unit within the terms of the assisted living contract.
new text end

new text begin Subd. 17. new text end

new text begin Right to choose roommate. new text end

new text begin Residents have the right to choose a roommate
if sharing a unit.
new text end

new text begin Subd. 18. new text end

new text begin Right to access food. new text end

new text begin Residents have the right to access food at any time.
This right may be restricted in certain circumstances if necessary for the resident's health
and safety and if documented in the resident's service plan.
new text end

new text begin Subd. 19. new text end

new text begin Access to technology. new text end

new text begin Residents have the right to access Internet service at
their expense.
new text end

new text begin Subd. 20. new text end

new text begin Grievances and inquiries. new text end

new text begin Residents have the right to make and receive a
timely response to a complaint or inquiry, without limitation. Residents have the right to
know and every facility must provide the name and contact information of the person
representing the facility who is designated to handle and resolve complaints and inquiries.
new text end

new text begin Subd. 21. new text end

new text begin Access to counsel and advocacy services. new text end

new text begin Residents have the right to the
immediate access by:
new text end

new text begin (1) the resident's legal counsel;
new text end

new text begin (2) any representative of the protection and advocacy system designated by the state
under Code of Federal Regulations, title 45, section 1326.21; or
new text end

new text begin (3) any representative of the Office of Ombudsman for Long-Term Care.
new text end

new text begin Subd. 22. new text end

new text begin Information about charges. new text end

new text begin Before services are initiated, residents have the
right to be notified:
new text end

new text begin (1) of all charges for housing and assisted living services;
new text end

new text begin (2) of any limits on housing and assisted living services available;
new text end

new text begin (3) if known, whether and what amount of payment may be expected from health
insurance, public programs, or other sources; and
new text end

new text begin (4) what charges the resident may be responsible for paying.
new text end

new text begin Subd. 23. new text end

new text begin Information about individuals providing services. new text end

new text begin Before receiving services
identified in the service plan, residents have the right to be told the type and disciplines of
staff who will be providing the services, the frequency of visits proposed to be furnished,
and other choices that are available for addressing the resident's needs.
new text end

new text begin Subd. 24. new text end

new text begin Information about other providers and services. new text end

new text begin Residents have the right
to be informed by the assisted living facility, prior to executing an assisted living contract,
that other public and private services may be available and that the resident has the right to
purchase, contract for, or obtain services from a provider other than the assisted living
facility.
new text end

new text begin Subd. 25. new text end

new text begin Resident councils. new text end

new text begin Residents have the right to organize and participate in
resident councils as described in section 144I.10, subdivision 5.
new text end

new text begin Subd. 26. new text end

new text begin Family councils. new text end

new text begin Residents have the right to participate in family councils
formed by families or residents as described in section 144I.10, subdivision 6.
new text end

Sec. 6.

new text begin [144J.03] RETALIATION PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Retaliation prohibited. new text end

new text begin A facility or agent of a facility may not retaliate
against a resident or employee if the resident, employee, or any person acting on behalf of
the resident:
new text end

new text begin (1) files a complaint or grievance, makes an inquiry, or asserts any right;
new text end

new text begin (2) indicates an intention to file a complaint or grievance, make an inquiry, or assert any
right;
new text end

new text begin (3) files or indicates an intention to file a maltreatment report, whether mandatory or
voluntary, under section 626.557;
new text end

new text begin (4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
problems or concerns to the director or manager of the facility, the Office of Ombudsman
for Long-Term Care, a regulatory or other government agency, or a legal or advocacy
organization;
new text end

new text begin (5) advocates or seeks advocacy assistance for necessary or improved care or services
or enforcement of rights under this section or other law;
new text end

new text begin (6) takes or indicates an intention to take civil action;
new text end

new text begin (7) participates or indicates an intention to participate in any investigation or
administrative or judicial proceeding;
new text end

new text begin (8) contracts or indicates an intention to contract to receive services from a service
provider of the resident's choice other than the facility; or
new text end

new text begin (9) places or indicates an intention to place a camera or electronic monitoring device in
the resident's private space as provided under section 144J.05.
new text end

new text begin Subd. 2. new text end

new text begin Retaliation against a resident. new text end

new text begin For purposes of this section, to retaliate against
a resident includes but is not limited to any of the following actions taken or threatened by
a facility or an agent of the facility against a resident, or any person with a familial, personal,
legal, or professional relationship with the resident:
new text end

new text begin (1) the discharge, eviction, transfer, or termination of services;
new text end

new text begin (2) the imposition of discipline, punishment, or a sanction or penalty;
new text end

new text begin (3) any form of discrimination;
new text end

new text begin (4) restriction or prohibition of access:
new text end

new text begin (i) of the resident to the facility or visitors; or
new text end

new text begin (ii) to the resident by a family member or a person with a personal, legal, or professional
relationship with the resident;
new text end

new text begin (5) the imposition of involuntary seclusion or withholding food, care, or services;
new text end

new text begin (6) restriction of any of the rights granted to residents under state or federal law;
new text end

new text begin (7) restriction or reduction of access to or use of amenities, care, services, privileges, or
living arrangements;
new text end

new text begin (8) an arbitrary increase in charges or fees;
new text end

new text begin (9) removing, tampering with, or deprivation of technology, communication, or electronic
monitoring devices; or
new text end

new text begin (10) any oral or written communication of false information about a person advocating
on behalf of the resident.
new text end

new text begin Subd. 3. new text end

new text begin Retaliation against an employee. new text end

new text begin For purposes of this section, to retaliate
against an employee includes but is not limited to any of the following actions taken or
threatened by the facility or an agent of the facility against an employee:
new text end

new text begin (1) discharge or transfer;
new text end

new text begin (2) demotion or refusal to promote;
new text end

new text begin (3) reduction in compensation, benefits, or privileges;
new text end

new text begin (4) the unwarranted imposition of discipline, punishment, or a sanction or penalty; or
new text end

new text begin (5) any form of discrimination.
new text end

new text begin Subd. 4. new text end

new text begin Rebuttable presumption of retaliation. new text end

new text begin (a) Except as provided in paragraphs
(b), (c), and (d), there is a rebuttable presumption that any action described in subdivision
2 or 3 and taken within 90 days of an initial action described in subdivision 1 is retaliatory.
new text end

new text begin (b) The presumption does not apply to actions described in subdivision 2, clause (4), if
a good faith report of maltreatment pursuant to section 626.557 is made by the facility or
agent of the facility against the visitor, family member, or other person with a personal,
legal, or professional relationship who is subject to the restriction or prohibition of access.
new text end

new text begin (c) The presumption does not apply to any oral or written communication described in
subdivision 2, clause (10), that is associated with a good faith report of maltreatment pursuant
to section 626.557 made by the facility or agent of the facility against the person advocating
on behalf of the resident.
new text end

new text begin (d) The presumption does not apply to a discharge, eviction, transfer, or termination of
services that occurs for a reason permitted under section 144J.08, subdivision 3 or 6, provided
the assisted living facility has complied with the applicable requirements in sections 144J.08
and 144.10.
new text end

new text begin Subd. 5. new text end

new text begin Other laws. new text end

new text begin Nothing in this section affects the rights available to a resident
under section 626.557.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 7.

new text begin [144J.04] DECEPTIVE MARKETING AND BUSINESS PRACTICES
PROHIBITED.
new text end

new text begin (a) No employee or agent of any facility may make any false, fraudulent, deceptive, or
misleading statements or representations or material omissions in marketing, advertising,
or any other description or representation of care or services.
new text end

new text begin (b) No assisted living contract may include any provision that the facility knows or
should know to be deceptive, unlawful, or unenforceable under state or federal law, nor
include any provision that requires or implies a lesser standard of care or responsibility than
is required by law.
new text end

new text begin (c) No facility may advertise or represent that it is licensed as an assisted living facility
with dementia care without complying with disclosure requirements under section 325F.72
and all additional requirements in chapter 144I and in rule.
new text end

new text begin (d) A violation of this section constitutes a violation of section 325F.69, subdivision 1.
The attorney general or a county attorney may enforce this section using the remedies in
section 325F.70.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 8.

new text begin [144J.05] ELECTRONIC MONITORING IN CERTAIN FACILITIES.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.
new text end

new text begin (b) "Commissioner" means the commissioner of health.
new text end

new text begin (c) "Department" means the Department of Health.
new text end

new text begin (d) "Electronic monitoring" means the placement and use of an electronic monitoring
device by a resident in the resident's room or private living unit in accordance with this
section.
new text end

new text begin (e) "Electronic monitoring device" means a camera or other device that captures, records,
or broadcasts audio, video, or both, that is placed in a resident's room or private living unit
and is used to monitor the resident or activities in the room or private living unit.
new text end

new text begin (f) "Facility" means a facility that is:
new text end

new text begin (1) licensed as a nursing home under chapter 144A;
new text end

new text begin (2) licensed as a boarding care home under sections 144.50 to 144.56;
new text end

new text begin (3) until August 1, 2021, a housing with services establishment registered under chapter
144D that is either subject to chapter 144G or has a disclosed special unit under section
325F.72; or
new text end

new text begin (4) on or after August 1, 2021, an assisted living facility.
new text end

new text begin (g) "Resident" means a person 18 years of age or older residing in a facility.
new text end

new text begin (h) "Resident representative" means one of the following in the order of priority listed,
to the extent the person may reasonably be identified and located:
new text end

new text begin (1) a court-appointed guardian;
new text end

new text begin (2) a health care agent as defined in section 145C.01, subdivision 2; or
new text end

new text begin (3) a person who is not an agent of a facility or of a home care provider designated in
writing by the resident and maintained in the resident's records on file with the facility or
with the resident's executed housing with services contract or nursing home contract.
new text end

new text begin Subd. 2. new text end

new text begin Electronic monitoring authorized. new text end

new text begin (a) A resident or a resident representative
may conduct electronic monitoring of the resident's room or private living unit through the
use of electronic monitoring devices placed in the resident's room or private living unit as
provided in this section.
new text end

new text begin (b) Nothing in this section precludes the use of electronic monitoring of health care
allowed under other law.
new text end

new text begin (c) Electronic monitoring authorized under this section is not a covered service under
home and community-based waivers under sections 256B.0913, 256B.0915, 256B.092, and
256B.49.
new text end

new text begin (d) This section does not apply to monitoring technology authorized as a home and
community-based service under section 256B.0913, 256B.0915, 256B.092, or 256B.49.
new text end

new text begin Subd. 3. new text end

new text begin Consent to electronic monitoring. new text end

new text begin (a) Except as otherwise provided in this
subdivision, a resident must consent to electronic monitoring in the resident's room or private
living unit in writing on a notification and consent form. If the resident has not affirmatively
objected to electronic monitoring and the resident's medical professional determines that
the resident currently lacks the ability to understand and appreciate the nature and
consequences of electronic monitoring, the resident representative may consent on behalf
of the resident. For purposes of this subdivision, a resident affirmatively objects when the
resident orally, visually, or through the use of auxiliary aids or services declines electronic
monitoring. The resident's response must be documented on the notification and consent
form.
new text end

new text begin (b) Prior to a resident representative consenting on behalf of a resident, the resident must
be asked if the resident wants electronic monitoring to be conducted. The resident
representative must explain to the resident:
new text end

new text begin (1) the type of electronic monitoring device to be used;
new text end

new text begin (2) the standard conditions that may be placed on the electronic monitoring device's use,
including those listed in subdivision 6;
new text end

new text begin (3) with whom the recording may be shared under subdivision 10 or 11; and
new text end

new text begin (4) the resident's ability to decline all recording.
new text end

new text begin (c) A resident, or resident representative when consenting on behalf of the resident, may
consent to electronic monitoring with any conditions of the resident's or resident
representative's choosing, including the list of standard conditions provided in subdivision
6. A resident, or resident representative when consenting on behalf of the resident, may
request that the electronic monitoring device be turned off or the visual or audio recording
component of the electronic monitoring device be blocked at any time.
new text end

new text begin (d) Prior to implementing electronic monitoring, a resident, or resident representative
when acting on behalf of the resident, must obtain the written consent on the notification
and consent form of any other resident residing in the shared room or shared private living
unit. A roommate's or roommate's resident representative's written consent must comply
with the requirements of paragraphs (a) to (c). Consent by a roommate or a roommate's
resident representative under this paragraph authorizes the resident's use of any recording
obtained under this section, as provided under subdivision 10 or 11.
new text end

new text begin (e) Any resident conducting electronic monitoring must immediately remove or disable
an electronic monitoring device prior to a new roommate moving into a shared room or
shared private living unit, unless the resident obtains the roommate's or roommate's resident
representative's written consent as provided under paragraph (d) prior to the roommate
moving into the shared room or shared private living unit. Upon obtaining the new
roommate's signed notification and consent form and submitting the form to the facility as
required under subdivision 5, the resident may resume electronic monitoring.
new text end

new text begin (f) The resident or roommate, or the resident representative or roommate's resident
representative if the representative is consenting on behalf of the resident or roommate, may
withdraw consent at any time and the withdrawal of consent must be documented on the
original consent form as provided under subdivision 5, paragraph (d).
new text end

new text begin Subd. 4. new text end

new text begin Refusal of roommate to consent. new text end

new text begin If a resident of a facility who is residing in
a shared room or shared living unit, or the resident representative of such a resident when
acting on behalf of the resident, wants to conduct electronic monitoring and another resident
living in or moving into the same shared room or shared living unit refuses to consent to
the use of an electronic monitoring device, the facility shall make a reasonable attempt to
accommodate the resident who wants to conduct electronic monitoring. A facility has met
the requirement to make a reasonable attempt to accommodate a resident or resident
representative who wants to conduct electronic monitoring when, upon notification that a
roommate has not consented to the use of an electronic monitoring device in the resident's
room, the facility offers to move the resident to another shared room or shared living unit
that is available at the time of the request. If a resident chooses to reside in a private room
or private living unit in a facility in order to accommodate the use of an electronic monitoring
device, the resident must pay either the private room rate in a nursing home setting, or the
applicable rent in a housing with services establishment or assisted living facility. If a facility
is unable to accommodate a resident due to lack of space, the facility must reevaluate the
request every two weeks until the request is fulfilled. A facility is not required to provide
a private room, a single-bed room, or a private living unit to a resident who is unable to
pay.
new text end

new text begin Subd. 5. new text end

new text begin Notice to facility; exceptions. new text end

new text begin (a) Electronic monitoring may begin only after
the resident or resident representative who intends to place an electronic monitoring device
and any roommate or roommate's resident representative completes the notification and
consent form and submits the form to the facility.
new text end

new text begin (b) Notwithstanding paragraph (a), the resident or resident representative who intends
to place an electronic monitoring device may do so without submitting a notification and
consent form to the facility for up to 30 days:
new text end

new text begin (1) if the resident or the resident representative reasonably fears retaliation against the
resident by the facility, timely submits the completed notification and consent form to the
Office of Ombudsman for Long-Term Care, and timely submits a Minnesota Adult Abuse
Reporting Center report or police report, or both, upon evidence from the electronic
monitoring device that suspected maltreatment has occurred;
new text end

new text begin (2) if there has not been a timely written response from the facility to a written
communication from the resident or resident representative expressing a concern prompting
the desire for placement of an electronic monitoring device and if the resident or a resident
representative timely submits a completed notification and consent form to the Office of
Ombudsman for Long-Term Care; or
new text end

new text begin (3) if the resident or resident representative has already submitted a Minnesota Adult
Abuse Reporting Center report or police report regarding the resident's concerns prompting
the desire for placement and if the resident or a resident representative timely submits a
completed notification and consent form to the Office of Ombudsman for Long-Term Care.
new text end

new text begin (c) Upon receipt of any completed notification and consent form, the facility must place
the original form in the resident's file or file the original form with the resident's housing
with services contract. The facility must provide a copy to the resident and the resident's
roommate, if applicable.
new text end

new text begin (d) In the event that a resident or roommate, or the resident representative or roommate's
resident representative if the representative is consenting on behalf of the resident or
roommate, chooses to alter the conditions under which consent to electronic monitoring is
given or chooses to withdraw consent to electronic monitoring, the facility must make
available the original notification and consent form so that it may be updated. Upon receipt
of the updated form, the facility must place the updated form in the resident's file or file the
original form with the resident's signed housing with services contract. The facility must
provide a copy of the updated form to the resident and the resident's roommate, if applicable.
new text end

new text begin (e) If a new roommate, or the new roommate's resident representative when consenting
on behalf of the new roommate, does not submit to the facility a completed notification and
consent form and the resident conducting the electronic monitoring does not remove or
disable the electronic monitoring device, the facility must remove the electronic monitoring
device.
new text end

new text begin (f) If a roommate, or the roommate's resident representative when withdrawing consent
on behalf of the roommate, submits an updated notification and consent form withdrawing
consent and the resident conducting electronic monitoring does not remove or disable the
electronic monitoring device, the facility must remove the electronic monitoring device.
new text end

new text begin Subd. 6. new text end

new text begin Form requirements. new text end

new text begin (a) The notification and consent form completed by the
resident must include, at a minimum, the following information:
new text end

new text begin (1) the resident's signed consent to electronic monitoring or the signature of the resident
representative, if applicable. If a person other than the resident signs the consent form, the
form must document the following:
new text end

new text begin (i) the date the resident was asked if the resident wants electronic monitoring to be
conducted;
new text end

new text begin (ii) who was present when the resident was asked;
new text end

new text begin (iii) an acknowledgment that the resident did not affirmatively object; and
new text end

new text begin (iv) the source of authority allowing the resident representative to sign the notification
and consent form on the resident's behalf;
new text end

new text begin (2) the resident's roommate's signed consent or the signature of the roommate's resident
representative, if applicable. If a roommate's resident representative signs the consent form,
the form must document the following:
new text end

new text begin (i) the date the roommate was asked if the roommate wants electronic monitoring to be
conducted;
new text end

new text begin (ii) who was present when the roommate was asked;
new text end

new text begin (iii) an acknowledgment that the roommate did not affirmatively object; and
new text end

new text begin (iv) the source of authority allowing the resident representative to sign the notification
and consent form on the roommate's behalf;
new text end

new text begin (3) the type of electronic monitoring device to be used;
new text end

new text begin (4) a list of standard conditions or restrictions that the resident or a roommate may elect
to place on the use of the electronic monitoring device, including but not limited to:
new text end

new text begin (i) prohibiting audio recording;
new text end

new text begin (ii) prohibiting video recording;
new text end

new text begin (iii) prohibiting broadcasting of audio or video;
new text end

new text begin (iv) turning off the electronic monitoring device or blocking the visual recording
component of the electronic monitoring device for the duration of an exam or procedure by
a health care professional;
new text end

new text begin (v) turning off the electronic monitoring device or blocking the visual recording
component of the electronic monitoring device while dressing or bathing is performed; and
new text end

new text begin (vi) turning off the electronic monitoring device for the duration of a visit with a spiritual
adviser, ombudsman, attorney, financial planner, intimate partner, or other visitor;
new text end

new text begin (5) any other condition or restriction elected by the resident or roommate on the use of
an electronic monitoring device;
new text end

new text begin (6) a statement of the circumstances under which a recording may be disseminated under
subdivision 10;
new text end

new text begin (7) a signature box for documenting that the resident or roommate has withdrawn consent;
and
new text end

new text begin (8) an acknowledgment that the resident, in accordance with subdivision 3, consents to
the Office of Ombudsman for Long-Term Care and its representatives disclosing information
about the form. Disclosure under this clause shall be limited to:
new text end

new text begin (i) the fact that the form was received from the resident or resident representative;
new text end

new text begin (ii) if signed by a resident representative, the name of the resident representative and
the source of authority allowing the resident representative to sign the notification and
consent form on the resident's behalf; and
new text end

new text begin (iii) the type of electronic monitoring device placed.
new text end

new text begin (b) Facilities must make the notification and consent form available to the residents and
inform residents of their option to conduct electronic monitoring of their rooms or private
living unit.
new text end

new text begin (c) Notification and consent forms received by the Office of Ombudsman for Long-Term
Care are classified under section 256.9744.
new text end

new text begin Subd. 7. new text end

new text begin Costs and installation. new text end

new text begin (a) A resident or resident representative choosing to
conduct electronic monitoring must do so at the resident's own expense, including paying
purchase, installation, maintenance, and removal costs.
new text end

new text begin (b) If a resident chooses to place an electronic monitoring device that uses Internet
technology for visual or audio monitoring, the resident may be responsible for contracting
with an Internet service provider.
new text end

new text begin (c) The facility shall make a reasonable attempt to accommodate the resident's installation
needs, including allowing access to the facility's public-use Internet or Wi-Fi systems when
available for other public uses. A facility has the burden of proving that a requested
accommodation is not reasonable.
new text end

new text begin (d) All electronic monitoring device installations and supporting services must be
UL-listed.
new text end

new text begin Subd. 8. new text end

new text begin Notice to visitors. new text end

new text begin (a) A facility must post a sign at each facility entrance
accessible to visitors that states: "Electronic monitoring devices, including security cameras
and audio devices, may be present to record persons and activities."
new text end

new text begin (b) The facility is responsible for installing and maintaining the signage required in this
subdivision.
new text end

new text begin Subd. 9. new text end

new text begin Obstruction of electronic monitoring devices. new text end

new text begin (a) A person must not knowingly
hamper, obstruct, tamper with, or destroy an electronic monitoring device placed in a
resident's room or private living unit without the permission of the resident or resident
representative.
new text end

new text begin (b) It is not a violation of paragraph (a) if a person turns off the electronic monitoring
device or blocks the visual recording component of the electronic monitoring device at the
direction of the resident or resident representative, or if consent has been withdrawn.
new text end

new text begin Subd. 10. new text end

new text begin Dissemination of recordings. new text end

new text begin (a) No person may access any video or audio
recording created through authorized electronic monitoring without the written consent of
the resident or resident representative.
new text end

new text begin (b) Except as required under other law, a recording or copy of a recording made as
provided in this section may only be disseminated for the purpose of addressing health,
safety, or welfare concerns of one or more residents.
new text end

new text begin (c) A person disseminating a recording or copy of a recording made as provided in this
section in violation of paragraph (b) may be civilly or criminally liable.
new text end

new text begin Subd. 11. new text end

new text begin Admissibility of evidence. new text end

new text begin Subject to applicable rules of evidence and
procedure, any video or audio recording created through electronic monitoring under this
section may be admitted into evidence in a civil, criminal, or administrative proceeding.
new text end

new text begin Subd. 12. new text end

new text begin Liability. new text end

new text begin (a) For the purposes of state law, the mere presence of an electronic
monitoring device in a resident's room or private living unit is not a violation of the resident's
right to privacy under section 144.651 or 144A.44.
new text end

new text begin (b) For the purposes of state law, a facility or home care provider is not civilly or
criminally liable for the mere disclosure by a resident or a resident representative of a
recording.
new text end

new text begin Subd. 13. new text end

new text begin Immunity from liability. new text end

new text begin The Office of Ombudsman for Long-Term Care
and representatives of the office are immune from liability for conduct described in section
256.9742, subdivision 2.
new text end

new text begin Subd. 14. new text end

new text begin Resident protections. new text end

new text begin (a) A facility must not:
new text end

new text begin (1) refuse to admit a potential resident or remove a resident because the facility disagrees
with the decision of the potential resident, the resident, or a resident representative acting
on behalf of the resident regarding electronic monitoring;
new text end

new text begin (2) retaliate or discriminate against any resident for consenting or refusing to consent
to electronic monitoring, as provided in section 144.6512, 144G.07, or 144J.03; or
new text end

new text begin (3) prevent the placement or use of an electronic monitoring device by a resident who
has provided the facility or the Office of Ombudsman for Long-Term Care with notice and
consent as required under this section.
new text end

new text begin (b) Any contractual provision prohibiting, limiting, or otherwise modifying the rights
and obligations in this section is contrary to public policy and is void and unenforceable.
new text end

new text begin Subd. 15. new text end

new text begin Employee discipline. new text end

new text begin (a) An employee of the facility or an employee of a
contractor providing services at the facility who is the subject of proposed corrective or
disciplinary action based upon evidence obtained by electronic monitoring must be given
access to that evidence for purposes of defending against the proposed action.
new text end

new text begin (b) An employee who obtains a recording or a copy of the recording must treat the
recording or copy confidentially and must not further disseminate it to any other person
except as required under law. Any copy of the recording must be returned to the facility or
resident who provided the copy when it is no longer needed for purposes of defending
against a proposed action.
new text end

new text begin Subd. 16. new text end

new text begin Penalties. new text end

new text begin (a) The commissioner may issue a correction order as provided
under section 144A.10, 144A.45, or 144A.474, upon a finding that the facility has failed to
comply with:
new text end

new text begin (1) subdivision 5, paragraphs (c) to (f);
new text end

new text begin (2) subdivision 6, paragraph (b);
new text end

new text begin (3) subdivision 7, paragraph (c); or
new text end

new text begin (4) subdivision 8, 9, 10, or 14.
new text end

new text begin (b) The commissioner may exercise the commissioner's authority under section 144D.05
to compel a housing with services establishment to meet the requirements of this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019, and applies to all contracts
in effect, entered into, or renewed on or after that date.
new text end

Sec. 9.

new text begin [144J.06] NO DISCRIMINATION BASED ON SOURCE OF PAYMENT.
new text end

new text begin All facilities must, regardless of the source of payment and for all persons seeking to
reside or residing in the facility:
new text end

new text begin (1) provide equal access to quality care; and
new text end

new text begin (2) establish, maintain, and implement identical policies and practices regarding residency,
transfer, and provision and termination of services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 10.

new text begin [144J.07] CONSUMER ADVOCACY AND LEGAL SERVICES.
new text end

new text begin Upon execution of an assisted living contract, every facility must provide the resident
and the resident's legal and designated representatives with the names and contact
information, including telephone numbers and e-mail addresses, of:
new text end

new text begin (1) nonprofit organizations that provide advocacy or legal services to residents including
but not limited to the designated protection and advocacy organization in Minnesota that
provides advice and representation to individuals with disabilities; and
new text end

new text begin (2) the Office of Ombudsman for Long-Term Care, including both the state and regional
contact information.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 11.

new text begin [144J.08] INVOLUNTARY DISCHARGES AND SERVICE
TERMINATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section and sections 144J.09 and
144J.10, the following terms have the meanings given them.
new text end

new text begin (b) "Facility" means:
new text end

new text begin (1) a housing with services establishment registered under section 144D.02 and operating
under title protection provided under chapter 144G; or
new text end

new text begin (2) on or after August 1, 2021, an assisted living facility.
new text end

new text begin (c) "Refusal to readmit" means a refusal by an assisted living facility, upon a request
from a resident or an agent of the resident, to allow the resident to return to the facility,
whether or not a notice of termination of housing or services has been issued.
new text end

new text begin (d) "Termination of housing or services" or "termination" means an involuntary
facility-initiated discharge, eviction, transfer, or service termination not initiated at the oral
or written request of the resident or to which the resident objects.
new text end

new text begin Subd. 2. new text end

new text begin Prerequisite to termination of housing or services. new text end

new text begin Before issuing a notice
of termination, a facility must explain in person and in detail the reasons for the termination,
and must convene a conference with the resident, the resident's legal representatives, the
resident's designated representative, the resident's family, applicable state and social services
agencies, and relevant health professionals to identify and offer reasonable accommodations
and modifications, interventions, or alternatives to avoid the termination.
new text end

new text begin Subd. 3. new text end

new text begin Permissible reasons to terminate housing or services. new text end

new text begin (a) A facility is
prohibited from terminating housing or services for grounds other than those specified in
paragraphs (b) and (c). A facility initiating a termination under paragraph (b) or (c) must
comply with subdivision 2.
new text end

new text begin (b) A facility may not initiate a termination unless the termination is necessary and the
facility produces a written determination, supported by documentation, of the necessity of
the termination. A termination is necessary only if:
new text end

new text begin (1) the resident has engaged in documented conduct that substantially interferes with
the rights, health, or safety of other residents;
new text end

new text begin (2) the resident has committed any of the acts enumerated under section 504B.171 that
substantially interfere with the rights, health, or safety of other residents; or
new text end

new text begin (3) the facility can demonstrate that the resident's needs exceed the scope of services for
which the resident contracted or which are included in the resident's service plan.
new text end

new text begin (c) A facility may initiate a termination for nonpayment, provided the facility:
new text end

new text begin (1) makes reasonable efforts to accommodate temporary financial hardship;
new text end

new text begin (2) informs the resident of private subsidies and public benefits options that may be
available, including but not limited to benefits available under sections 256B.0915 and
256B.49; and
new text end

new text begin (3) if the resident applies for public benefits, timely responds to state or county agency
questions regarding the application.
new text end

new text begin (d) A facility may not initiate a termination of housing or services to a resident receiving
public benefits in the event of a temporary interruption in benefits. A temporary interruption
of benefits does not constitute nonpayment.
new text end

new text begin Subd. 4. new text end

new text begin Notice of termination required. new text end

new text begin (a) A facility initiating a termination of housing
or services must issue a written notice that complies with subdivision 5 at least 30 days
prior to the effective date of the termination to the resident, to the resident's legal
representative and designated representative, or if none, to a family member if known, and
to the Ombudsman for Long-Term Care.
new text end

new text begin (b) A facility may relocate a resident with less than 30 days' notice only in the event of
emergencies, as provided in subdivision 6.
new text end

new text begin (c) The notice requirements in paragraph (a) do not apply if the facility's license is
restricted by the commissioner or the facility ceases operations. In the event of a license
restriction or cessation of operations, the facility must follow the commissioner's directions
for resident relocations contained in section 144J.10.
new text end

new text begin Subd. 5. new text end

new text begin Content of notice. new text end

new text begin The notice required under subdivision 4 must contain, at a
minimum:
new text end

new text begin (1) the effective date of the termination;
new text end

new text begin (2) a detailed explanation of the basis for the termination, including, but not limited to,
clinical or other supporting rationale;
new text end

new text begin (3) contact information for, and a statement that the resident has the right to appeal the
termination to, the Office of Administrative Hearings;
new text end

new text begin (4) contact information for the Ombudsman for Long-Term Care;
new text end

new text begin (5) the name and contact information of a person employed by the facility with whom
the resident may discuss the notice of termination of housing or services;
new text end

new text begin (6) if the termination is for services, a statement that the notice of termination of services
does not constitute a termination of housing or an eviction from the resident's home, and
that the resident has the right to remain in the facility if the resident can secure necessary
services from another provider of the resident's choosing; and
new text end

new text begin (7) if the resident must relocate:
new text end

new text begin (i) a statement that the facility must actively participate in a coordinated transfer of the
resident's care to a safe and appropriate service provider; and
new text end

new text begin (ii) the name of and contact information for the new location or provider, or a statement
that the location or provider must be identified prior to the effective date of the termination.
new text end

new text begin Subd. 6. new text end

new text begin Exception for emergencies. new text end

new text begin (a) A facility may relocate a resident from a facility
with less than 30 days' notice if relocation is required:
new text end

new text begin (1) due to a resident's urgent medical needs and is ordered by a licensed health care
professional; or
new text end

new text begin (2) because of an imminent risk to the health or safety of another resident or a staff
member of the facility.
new text end

new text begin (b) A facility relocating a resident under this subdivision must:
new text end

new text begin (1) remove the resident to an appropriate location. A private home where the occupant
is unwilling or unable to care for the resident, a homeless shelter, a hotel, or a motel is not
an appropriate location; and
new text end

new text begin (2) provide notice of the contact information for and location to which the resident has
been relocated, contact information for any new service provider and for the Ombudsman
for Long-Term Care, the reason for the relocation, a statement that, if the resident is refused
readmission to the facility, the resident has the right to appeal any refusal to readmit to the
Office of Administrative Hearings, and, if ascertainable, the approximate date or range of
dates when the resident is expected to return to the facility or a statement that such date is
not currently ascertainable, to:
new text end

new text begin (i) the resident, the resident's legal representative and designated representative, or if
none, a family member if known immediately upon relocation of the resident; and
new text end

new text begin (ii) the Office of Ombudsman for Long-Term Care as soon as practicable if the resident
has been relocated from the facility for more than 48 hours.
new text end

new text begin (c) The resident has the right to return to the facility if the conditions under paragraph
(a) no longer exist.
new text end

new text begin (d) If the facility determines that the resident cannot return to the facility or the facility
cannot provide the necessary services to the resident upon return, the facility must as soon
as practicable but in no event later than 24 hours after the refusal or determination, comply
with subdivision 4, and section 144J.10.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin (a) This section is effective August 1, 2019, and expires July 31,
2021, for housing with services establishments registered under section 144D.02 and
operating under title protection provided by and subject to chapter 144G.
new text end

new text begin (b) This section is effective for assisted living facilities August 1, 2021.
new text end

Sec. 12.

new text begin [144J.09] APPEAL OF TERMINATION OF HOUSING OR SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Right to appeal termination of housing or services. new text end

new text begin A resident, the
resident's legal representative or designated representative, or a family member, has the
right to appeal a termination of housing or services or a facility's refusal to readmit the
resident after an emergency relocation and to request a contested case hearing with the
Office of Administrative Hearings.
new text end

new text begin Subd. 2. new text end

new text begin Appeals process. new text end

new text begin (a) An appeal and request for a contested case hearing must
be filed in writing or electronically as authorized by the chief administrative law judge.
new text end

new text begin (b) The Office of Administrative Hearings must conduct an expedited hearing as soon
as practicable, and in any event no later than 14 calendar days after the office receives the
request and within three business days in the event of an appeal of a refusal to readmit. The
hearing must be held at the facility where the resident lives, unless it is impractical or the
parties agree to a different place. The hearing is not a formal evidentiary hearing. The hearing
may also be attended by telephone as allowed by the administrative law judge, after
considering how a telephonic hearing will affect the resident's ability to participate. The
hearing shall be limited to the amount of time necessary for the participants to expeditiously
present the facts about the proposed termination or refusal to readmit. The administrative
law judge shall issue a recommendation to the commissioner as soon as practicable, and in
any event no later than ten calendar days after the hearing or within two calendar days after
the hearing in the case of a refusal to readmit.
new text end

new text begin (c) The facility bears the burden of proof to establish by a preponderance of the evidence
that the termination of housing or services or the refusal to readmit is permissible under law
and does not constitute retaliation under section 144G.07 or 144J.03.
new text end

new text begin (d) Appeals from final determinations issued by the Office of Administrative Hearings
shall be as provided in sections 14.63 to 14.68.
new text end

new text begin (e) The Office of Administrative Hearings must grant the appeal and the commissioner
of health may order the assisted living facility to rescind the termination of housing and
services or readmit the resident if:
new text end

new text begin (1) the termination or refusal to readmit was in violation of state or federal law;
new text end

new text begin (2) the resident cures or demonstrates the ability to cure the reason for the termination
or refusal to readmit, or has identified any reasonable accommodation or modification,
intervention, or alternative to the termination;
new text end

new text begin (3) termination would result in great harm or potential great harm to the resident as
determined by a totality of the circumstances; or
new text end

new text begin (4) the facility has failed to identify a safe and appropriate location to which the resident
is to be relocated as required under section 144J.10.
new text end

new text begin (f) The Office of Administrative Hearings has the authority to make any other
determinations or orders regarding any conditions that may be placed upon the resident's
readmission or continued residency, including but not limited to changes to the service plan
or required increases in services.
new text end

new text begin (g) Nothing in this section limits the right of a resident or the resident's designated
representative to request or receive assistance from the Office of Ombudsman for Long-Term
Care and the protection and advocacy agency protection and advocacy system designated
by the state under Code of Federal Regulations, title 45, section 1326.21, concerning the
termination of housing or services.
new text end

new text begin Subd. 3. new text end

new text begin Representation at the hearing. new text end

new text begin Parties may, but are not required to, be
represented by counsel at a contested case hearing on an appeal. The appearance of a party
without counsel does not constitute the unauthorized practice of law.
new text end

new text begin Subd. 4. new text end

new text begin Service provision while appeal pending. new text end

new text begin Housing or services may not be
terminated during the pendency of an appeal and until a final determination is made by the
Office of Administrative Hearings.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin (a) This section is effective August 1, 2019, and expires July 31,
2021, for housing with services establishments registered under section 144D.02 and
operating under title protection provided by and subject to chapter 144G.
new text end

new text begin (b) This section is effective for assisted living facilities August 1, 2021.
new text end

Sec. 13.

new text begin [144J.10] HOUSING AND SERVICE TERMINATION; RELOCATION
PLANNING.
new text end

new text begin Subdivision 1. new text end

new text begin Duties of the facility. new text end

new text begin If a facility terminates housing or services, if a
facility intends to cease operations, or if a facility's license is restricted by the commissioner
requiring termination of housing or services to residents, the facility:
new text end

new text begin (1) in the event of a termination of housing, has an affirmative duty to ensure a
coordinated and orderly transfer of the resident to a safe location that is appropriate for the
resident. The facility must identify that location prior to any appeal hearing;
new text end

new text begin (2) in the event of a termination of services, has an affirmative duty to ensure a
coordinated and orderly transfer of the resident to an appropriate service provider, if services
are still needed and desired by the resident. The facility must identify the provider prior to
any appeal hearing; and
new text end

new text begin (3) must consult and cooperate with the resident; the resident's legal representatives,
designated representative, and family members; any interested professionals, including case
managers; and applicable agencies to consider the resident's goals and make arrangements
to relocate the resident.
new text end

new text begin Subd. 2. new text end

new text begin Safe location. new text end

new text begin A safe location is not a private home where the occupant is
unwilling or unable to care for the resident, a homeless shelter, a hotel, or a motel. A facility
may not terminate a resident's housing or services if the resident will, as a result of the
termination, become homeless, as that term is defined in section 116L.361, subdivision 5,
or if an adequate and safe discharge location or adequate and needed service provider has
not been identified.
new text end

new text begin Subd. 3. new text end

new text begin Written relocation plan required. new text end

new text begin The facility must prepare a written relocation
plan for a resident being relocated. The plan must:
new text end

new text begin (1) contain all the necessary steps to be taken to reduce transfer trauma; and
new text end

new text begin (2) specify the measures needed until relocation that protect the resident and meet the
resident's health and safety needs.
new text end

new text begin Subd. 4. new text end

new text begin No relocation without receiving setting accepting. new text end

new text begin A facility may not relocate
the resident unless the place to which the resident will be relocated indicates acceptance of
the resident.
new text end

new text begin Subd. 5. new text end

new text begin No termination of services without another provider. new text end

new text begin If a resident continues
to need and desire the services provided by the facility, the facility may not terminate services
unless another service provider has indicated that it will provide those services.
new text end

new text begin Subd. 6. new text end

new text begin Information that must be conveyed. new text end

new text begin If a resident is relocated to another facility
or to a nursing home, or if care is transferred to another provider, the facility must timely
convey to that facility, nursing home, or provider:
new text end

new text begin (1) the resident's full name, date of birth, and insurance information;
new text end

new text begin (2) the name, telephone number, and address of the resident's designated representatives
and legal representatives, if any;
new text end

new text begin (3) the resident's current documented diagnoses that are relevant to the services being
provided;
new text end

new text begin (4) the resident's known allergies that are relevant to the services being provided;
new text end

new text begin (5) the name and telephone number of the resident's physician, if known, and the current
physician orders that are relevant to the services being provided;
new text end

new text begin (6) all medication administration records that are relevant to the services being provided;
new text end

new text begin (7) the most recent resident assessment, if relevant to the services being provided; and
new text end

new text begin (8) copies of health care directives, "do not resuscitate" orders, and any guardianship
orders or powers of attorney.
new text end

new text begin Subd. 7. new text end

new text begin Final accounting; return of money and property. new text end

new text begin (a) Within 30 days of the
effective date of the termination of housing or services, the facility must:
new text end

new text begin (1) provide to the resident, resident's legal representatives, and the resident's designated
representative a final statement of account;
new text end

new text begin (2) provide any refunds due;
new text end

new text begin (3) return any money, property, or valuables held in trust or custody by the facility; and
new text end

new text begin (4) as required under section 504B.178, refund the resident's security deposit unless it
is applied to the first month's charges.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin (a) This section is effective August 1, 2019, and expires July 31,
2021, for housing with services establishments registered under section 144D.02 and
operating under title protection provided by and subject to chapter 144G.
new text end

new text begin (b) This section is effective for assisted living facilities August 1, 2021.
new text end

Sec. 14.

new text begin [144J.11] FORCED ARBITRATION.
new text end

new text begin (a) An assisted living facility must affirmatively disclose, orally and conspicuously in
writing in an assisted living contract, any arbitration provision in the contract that precludes,
limits, or delays the ability of a resident from taking a civil action.
new text end

new text begin (b) A forced arbitration requirement must not include a choice of law or choice of venue
provision. Assisted living contracts must adhere to Minnesota law and any other applicable
federal or local law. Any civil actions by any litigant must be taken in Minnesota judicial
or administrative courts.
new text end

new text begin (c) A forced arbitration provision must not be unconscionable. All or the portion of a
forced arbitration provision found by a court to be unconscionable shall have no effect on
the remaining provisions, terms, or conditions of the contract.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019, for contracts entered
into on or after that date.
new text end

Sec. 15.

new text begin [144J.12] VIOLATION OF RIGHTS.
new text end

new text begin (a) A resident who meets the criteria under section 325F.71, subdivision 1, has a cause
of action under section 325F.71, subdivision 4, for the violation of section 144J.02,
subdivision 8, 15, or 21, or section 144J.04.
new text end

new text begin (b) A resident who meets the criteria under section 325F.71, subdivision 1, has a cause
of action under section 325F.71, subdivision 4, for the violation of section 144J.03, unless
the resident otherwise has a cause of action under section 626.557, subdivision 17.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 16.

new text begin [144J.13] APPLICABILITY OF OTHER LAWS.
new text end

new text begin Assisted living facilities:
new text end

new text begin (1) are subject to and must comply with chapter 504B;
new text end

new text begin (2) must comply with section 325F.72; and
new text end

new text begin (3) are not required to obtain a lodging license under chapter 157 and related rules.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 17.

Minnesota Statutes 2018, section 325F.72, subdivision 4, is amended to read:

Subd. 4.

Remedy.

The attorney general may seek the remedies set forth in section 8.31
for repeated and intentional violations of this section. deleted text beginHowever, no private right of action
may be maintained as provided under section 8.31, subdivision 3a.
deleted text end

ARTICLE 2

INDEPENDENT SENIOR LIVING FACILITIES

Section 1.

new text begin [144K.01] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin For the purposes of this chapter, the definitions in this
section have the meanings given.
new text end

new text begin Subd. 2. new text end

new text begin Dementia. new text end

new text begin "Dementia" has the meaning given in section 144I.01, subdivision
16.
new text end

new text begin Subd. 3. new text end

new text begin Designated representative. new text end

new text begin "Designated representative" means a person
designated in writing by the resident in a residency and services contract and identified in
the resident's records on file with the independent senior living facility.
new text end

new text begin Subd. 4. new text end

new text begin Facility. new text end

new text begin "Facility" means an independent senior living facility.
new text end

new text begin Subd. 5. new text end

new text begin "I'm okay" check services. new text end

new text begin ""I'm okay" check services" means having,
maintaining, and documenting a system to, by any means, check on the health, safety, and
well-being of a resident a minimum of once daily or more frequently according to the
residency and services contract.
new text end

new text begin Subd. 6. new text end

new text begin Independent senior living facility. new text end

new text begin "Independent senior living facility" means
a facility that for a fee provides sleeping accommodations to one or more adults and offers
or provides one or more supportive services directly or through a related supportive services
provider. An independent senior living facility may also provide "I'm okay" check services
directly or through a related supportive services provider. For purposes of this chapter,
independent senior living facility does not include:
new text end

new text begin (1) emergency shelter, transitional housing, or any other residential units serving
exclusively or primarily homeless individuals, as defined under section 116L.361;
new text end

new text begin (2) a nursing home licensed under chapter 144A;
new text end

new text begin (3) a hospital, certified boarding care home, or supervised living facility licensed under
sections 144.50 to 144.56;
new text end

new text begin (4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts
9520.0500 to 9520.0670, or under chapter 245D or 245G;
new text end

new text begin (5) a lodging establishment serving as a shelter for individuals fleeing domestic violence;
new text end

new text begin (6) services and residential settings licensed under chapter 245A, including adult foster
care and services and settings governed under the standards in chapter 245D;
new text end

new text begin (7) private homes where the residents own or rent the home and control all aspects of
the property and building;
new text end

new text begin (8) a duly organized condominium, cooperative, and common interest community, or
owners' association of the condominium, cooperative, and common interest community
where at least 80 percent of the units that comprise the condominium, cooperative, or
common interest community are occupied by individuals who are the owners, members, or
shareholders of the units;
new text end

new text begin (9) temporary family health care dwellings as defined in sections 394.307 and 462.3593;
new text end

new text begin (10) settings offering services conducted by and for the adherents of any recognized
church or religious denomination for its members through spiritual means or by prayer for
healing;
new text end

new text begin (11) housing financed pursuant to sections 462A.37 and 462A.375, units financed with
low-income housing tax credits pursuant to United States Code, title 26, section 42, and
units financed by the Minnesota Housing Finance Agency that are intended to serve
individuals with disabilities or individuals who are homeless;
new text end

new text begin (12) rental housing developed under United States Code, title 42, section 1437, or United
States Code, title 12, section 1701q;
new text end

new text begin (13) rental housing designated for occupancy by only elderly or elderly and disabled
residents under United States Code, title 42, section 1437e, or rental housing for qualifying
families under Code of Federal Regulations, title 24, section 983.56;
new text end

new text begin (14) rental housing funded under United States Code, title 42, chapter 89, or United
States Code, title 42, section 8011; or
new text end

new text begin (15) an assisted living facility or assisted living facility with dementia care licensed
under chapter 144I.
new text end

new text begin Subd. 7. new text end

new text begin Manager. new text end

new text begin "Manager" means a manager of an independent senior living facility.
new text end

new text begin Subd. 8. new text end

new text begin Residency and services contract or contract. new text end

new text begin "Residency and services contract"
or "contract" means the legal agreement between an independent senior living facility and
a resident for the provision of housing, supportive services, and "I'm okay" check services.
new text end

new text begin Subd. 9. new text end

new text begin Related supportive services provider. new text end

new text begin "Related supportive services provider"
means a service provider that provides supportive services or "I'm okay" check services to
a resident under a business relationship or other affiliation with the independent senior living
facility.
new text end

new text begin Subd. 10. new text end

new text begin Resident. new text end

new text begin "Resident" means a person residing in an independent senior living
facility.
new text end

new text begin Subd. 11. new text end

new text begin Supportive services. new text end

new text begin "Supportive services" means:
new text end

new text begin (1) assistance with laundry, shopping, and household chores;
new text end

new text begin (2) housekeeping services;
new text end

new text begin (3) provision of meals or assistance with meals or food preparation;
new text end

new text begin (4) help with arranging, or arranging transportation to, medical, social, recreational,
personal, or social services appointments; or
new text end

new text begin (5) provision of social or recreational services.
new text end

new text begin Arranging for services does not include making referrals or contacting a service provider
in an emergency.
new text end

Sec. 2.

new text begin [144K.02] DECEPTIVE MARKETING AND BUSINESS PRACTICES
PROHIBITED.
new text end

new text begin (a) No employee or agent of any independent senior living facility may make any false,
fraudulent, deceptive, or misleading statements or representations or material omissions in
marketing, advertising, or any other description or representation of care or services.
new text end

new text begin (b) No residency and services contract required under section 144K.03, subdivision 1,
may include any provision that the facility knows or should know to be deceptive, unlawful,
or unenforceable under state or federal law.
new text end

new text begin (c) No facility may advertise or represent that the facility is an assisted living facility as
defined in section 144I.01, subdivision 7, or an assisted living facility with dementia care
as defined in section 144I.01, subdivision 8.
new text end

Sec. 3.

new text begin [144K.025] REQUIRED DISCLOSURE BY FACILITY.
new text end

new text begin An independent senior living facility must disclose to prospective residents and residents
that the facility is not licensed as an assisted living facility and is not permitted to provide
assisted living services, as defined in section 144I.01, subdivision 9, either directly or through
a provider under a business relationship or other affiliation with the facility.
new text end

Sec. 4.

new text begin [144K.03] RESIDENCY AND SERVICES CONTRACT.
new text end

new text begin Subdivision 1. new text end

new text begin Contract required. new text end

new text begin (a) No independent senior living facility may operate
in this state unless a written contract that meets the requirements of subdivision 2 is executed
between the facility and each resident and unless the establishment operates in accordance
with the terms of the contract.
new text end

new text begin (b) The facility must give a complete copy of any signed contract and any addendums,
and all supporting documents and attachments, to the resident promptly after a contract and
any addendums have been signed by the resident.
new text end

new text begin (c) The contract must contain all the terms concerning the provision of housing,
supportive services, and "I'm okay" check services whether the services are provided directly
or through a related supportive services provider.
new text end

new text begin Subd. 2. new text end

new text begin Contents of contract. new text end

new text begin A residency and services contract must include at least
the following elements in itself or through supporting documents or attachments:
new text end

new text begin (1) the name, telephone number, and physical mailing address, which may not be a
public or private post office box, of:
new text end

new text begin (i) the facility and, where applicable, the related supportive services provider;
new text end

new text begin (ii) the managing agent of the facility, if applicable; and
new text end

new text begin (iii) at least one natural person who is authorized to accept service of process on behalf
of the facility;
new text end

new text begin (2) the term of the contract;
new text end

new text begin (3) a description of all the terms and conditions of the contract, including a description
of the services to be provided and any limitations to the services provided to the resident
for the contracted amount;
new text end

new text begin (4) a delineation of the grounds under which the resident may be evicted or have services
terminated;
new text end

new text begin (5) billing and payment procedures and requirements;
new text end

new text begin (6) a statement regarding the ability of a resident to receive services from service
providers with whom the facility does not have a business relationship;
new text end

new text begin (7) a description of the facility's complaint resolution process available to residents,
including the name and contact information of the person representing the facility who is
designated to handle and resolve complaints;
new text end

new text begin (8) the toll-free complaint line for the Office of Ombudsman for Long-Term Care; and
new text end

new text begin (9) a statement regarding the availability of and contact information for long-term care
consultation services under section 256B.0911 in the county in which the facility is located.
new text end

new text begin Subd. 3. new text end

new text begin Designation of representative. new text end

new text begin (a) Before or at the time of execution of a
residency and services contract, every facility must offer the resident the opportunity to
identify a designated representative in writing in the contract and provide the following
verbatim notice on a document separate from the contract:
new text end

new text begin RIGHT TO DESIGNATE A REPRESENTATIVE FOR CERTAIN PURPOSES.
new text end

new text begin You have the right to name anyone as your "Designated Representative" to assist you
or, if you are unable, advocate on your behalf. A "Designated Representative" does not take
the place of your guardian, conservator, power of attorney ("attorney-in-fact"), or health
care power of attorney ("health care agent").
new text end

new text begin (b) The contract must contain a page or space for the name and contact information of
the designated representative and a box the resident must initial if the resident declines to
name a designated representative. Notwithstanding subdivision 5, the resident has the right
at any time to add or change the name and contact information of the designated
representative.
new text end

new text begin Subd. 4. new text end

new text begin Contracts are consumer contracts. new text end

new text begin A contract under this section is a consumer
contract under sections 325G.29 to 325G.37.
new text end

new text begin Subd. 5. new text end

new text begin Additions and amendments to contract. new text end

new text begin The resident must agree in writing
to any additions or amendments to the contract. Upon agreement between the resident or
resident's designated representative and the facility, a new contract or an addendum to the
existing contract must be executed and signed and provided to the resident and the resident's
legal representative.
new text end

new text begin Subd. 6. new text end

new text begin Contracts in permanent files. new text end

new text begin Residency and services contracts and related
documents executed by each resident must be maintained by the facility in files from the
date of execution until three years after the contract is terminated.
new text end

new text begin Subd. 7. new text end

new text begin Waivers of liability prohibited. new text end

new text begin The contract must not include a waiver of
facility liability for the health and safety or personal property of a resident. The contract
must not include any provision that the facility knows or should know to be deceptive,
unlawful, or unenforceable under state or federal law, and must not include any provision
that requires or implies a lesser standard of responsibility than is required by law.
new text end

Sec. 5.

new text begin [144K.04] TERMINATION OF RESIDENCY AND SERVICES CONTRACT.
new text end

new text begin Subdivision 1. new text end

new text begin Notice required. new text end

new text begin An independent senior living facility must provide at
least 30 days prior notice of a termination of the residency and services contract.
new text end

new text begin Subd. 2. new text end

new text begin Content of notice. new text end

new text begin The notice required under subdivision 1 must contain, at a
minimum:
new text end

new text begin (1) the effective date of termination of the contract;
new text end

new text begin (2) a detailed explanation of the basis for the termination;
new text end

new text begin (3) a list of known facilities in the immediate geographic area;
new text end

new text begin (4) information on how to contact the Office of Ombudsman for Long-Term Care and
the Ombudsman for Mental Health and Developmental Disabilities;
new text end

new text begin (6) a statement of any steps the resident can take to avoid termination;
new text end

new text begin (7) the name and contact information of a person employed by the facility with whom
the resident may discuss the notice of termination and, without extending the termination
notice period, an affirmative offer to meet with the resident and any person or persons of
the resident's choosing to discuss the termination;
new text end

new text begin (8) a statement that, with respect to the notice of termination, reasonable accommodation
is available for a resident with a disability; and
new text end

new text begin (9) an explanation that:
new text end

new text begin (i) the resident must vacate the apartment, along with all personal possessions, on or
before the effective date of termination;
new text end

new text begin (ii) failure to vacate the apartment by the date of termination may result in the filing of
an eviction action in court by the facility, and that the resident may present a defense, if
any, to the court at that time; and
new text end

new text begin (iii) the resident may seek legal counsel in connection with the notice of termination.
new text end

Sec. 6.

new text begin [144K.05] MANAGER REQUIREMENTS.
new text end

new text begin (a) The manager of an independent senior living facility must obtain at least 30 hours
of continuing education every two years of employment as the manager in topics relevant
to the operations of the facility and the needs of its residents. Continuing education earned
to maintain a professional license, such as a nursing home administrator license, nursing
license, social worker license, or real estate license, may be used to satisfy this requirement.
The continuing education must include at least four hours of documented training on dementia
and related disorders, activities of daily living, problem solving with challenging behaviors,
and communication skills within 160 working hours of hire and two hours of training on
these topics for each 12 months of employment thereafter.
new text end

new text begin (b) The facility must maintain records for at least three years demonstrating that the
manager has attended educational programs as required by this section. New managers may
satisfy the initial dementia training requirements by producing written proof of having
previously completed required training within the past 18 months.
new text end

Sec. 7.

new text begin [144K.06] FIRE PROTECTION AND PHYSICAL ENVIRONMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Comprehensive fire protection system required. new text end

new text begin Every independent
senior living facility must have a comprehensive fire protection system that includes:
new text end

new text begin (1) protection throughout the facility by an approved supervised automatic sprinkler
system according to building code requirements established in Minnesota Rules, part
1305.0903, or smoke detectors in each occupied room installed and maintained in accordance
with the National Fire Protection Association (NFPA) Standard 72;
new text end

new text begin (2) portable fire extinguishers installed and tested in accordance with the NFPA Standard
10; and
new text end

new text begin (3) the physical environment, including walls, floors, ceiling, all furnishings, grounds,
systems, and equipment kept in a continuous state of good repair and operation with regard
to the health, safety, comfort, and well-being of the residents in accordance with a
maintenance and repair program.
new text end

new text begin Subd. 2. new text end

new text begin Fire drills. new text end

new text begin Fire drills shall be conducted in accordance with the residential
board and care requirements in the Life Safety Code.
new text end

Sec. 8.

new text begin [144K.07] EMERGENCY PLANNING.
new text end

new text begin Subdivision 1. new text end

new text begin Requirements. new text end

new text begin Each independent senior living facility must meet the
following requirements:
new text end

new text begin (1) have a written emergency disaster plan that contains a plan for evacuation, addresses
elements of sheltering in-place, identifies temporary relocation sites, and details staff
assignments in the event of a disaster or an emergency;
new text end

new text begin (2) post an emergency disaster plan prominently;
new text end

new text begin (3) provide building emergency exit diagrams to all residents upon signing a residency
and services contract;
new text end

new text begin (4) post emergency exit diagrams on each floor; and
new text end

new text begin (5) have a written policy and procedure regarding missing residents.
new text end

new text begin Subd. 2. new text end

new text begin Emergency and disaster training. new text end

new text begin Each independent senior living facility
must provide emergency and disaster training to all staff during the initial staff orientation
and annually thereafter and must make emergency and disaster training available to all
residents annually. Staff who have not received emergency and disaster training are allowed
to work only when trained staff are also working on site.
new text end

Sec. 9.

new text begin [144K.08] OTHER LAWS.
new text end

new text begin An independent senior living facility must comply with chapter 504B and must obtain
and maintain all other licenses, permits, registrations, or other governmental approvals
required of it.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 10.

new text begin [144K.09] ENFORCEMENT.
new text end

new text begin (a) A violation of this chapter constitutes a violation of section 325F.69, subdivision 1.
The attorney general may enforce this section using the remedies in section 325F.70.
new text end

new text begin (b) A resident who meets the criteria in section 325F.71, subdivision 1, has a cause of
action under section 325F.71, subdivision 4, for a violation of this chapter.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

ARTICLE 3

ASSISTED LIVING LICENSURE

Section 1.

Minnesota Statutes 2018, section 144.122, is amended to read:

144.122 LICENSE, PERMIT, AND SURVEY FEES.

(a) The state commissioner of health, by rule, may prescribe procedures and fees for
filing with the commissioner as prescribed by statute and for the issuance of original and
renewal permits, licenses, registrations, and certifications issued under authority of the
commissioner. The expiration dates of the various licenses, permits, registrations, and
certifications as prescribed by the rules shall be plainly marked thereon. Fees may include
application and examination fees and a penalty fee for renewal applications submitted after
the expiration date of the previously issued permit, license, registration, and certification.
The commissioner may also prescribe, by rule, reduced fees for permits, licenses,
registrations, and certifications when the application therefor is submitted during the last
three months of the permit, license, registration, or certification period. Fees proposed to
be prescribed in the rules shall be first approved by the Department of Management and
Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
in an amount so that the total fees collected by the commissioner will, where practical,
approximate the cost to the commissioner in administering the program. All fees collected
shall be deposited in the state treasury and credited to the state government special revenue
fund unless otherwise specifically appropriated by law for specific purposes.

(b) The commissioner may charge a fee for voluntary certification of medical laboratories
and environmental laboratories, and for environmental and medical laboratory services
provided by the department, without complying with paragraph (a) or chapter 14. Fees
charged for environment and medical laboratory services provided by the department must
be approximately equal to the costs of providing the services.

(c) The commissioner may develop a schedule of fees for diagnostic evaluations
conducted at clinics held by the services for children with disabilities program. All receipts
generated by the program are annually appropriated to the commissioner for use in the
maternal and child health program.

(d) The commissioner shall set license fees for hospitals and nursing homes that are not
boarding care homes at the following levels:

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and American Osteopathic Association (AOA) hospitals	$7,655 plus $16 per bed
Non-JCAHO and non-AOA hospitals	$5,280 plus $250 per bed
Nursing home	$183 plus $91 per bed until June 30, 2018. $183 plus $100 per bed between July 1, 2018, and June 30, 2020. $183 plus $105 per bed beginning July 1, 2020.

The commissioner shall set license fees for outpatient surgical centers, boarding care
homes, deleted text beginand deleted text end supervised living facilities new text begin, assisted living facilities, and assisted living facilities
with dementia care new text end at the following levels:

Outpatient surgical centers	$3,712
Boarding care homes	$183 plus $91 per bed
Supervised living facilities	$183 plus $91 per bed.
new text begin Assisted living facilities with dementia care new text end	new text begin $....... plus $....... per bed. new text end
new text begin Assisted living facilities new text end	new text begin $....... plus $....... per bed. new text end

Fees collected under this paragraph are nonrefundable. The fees are nonrefundable even if
received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017,
or later.

(e) Unless prohibited by federal law, the commissioner of health shall charge applicants
the following fees to cover the cost of any initial certification surveys required to determine
a provider's eligibility to participate in the Medicare or Medicaid program:

Prospective payment surveys for hospitals	$	900
Swing bed surveys for nursing homes	$	1,200
Psychiatric hospitals	$	1,400
Rural health facilities	$	1,100
Portable x-ray providers	$	500
Home health agencies	$	1,800
Outpatient therapy agencies	$	800
End stage renal dialysis providers	$	2,100
Independent therapists	$	800
Comprehensive rehabilitation outpatient facilities	$	1,200
Hospice providers	$	1,700
Ambulatory surgical providers	$	1,800
Hospitals	$	4,200
Other provider categories or additional resurveys required to complete initial certification	Actual surveyor costs: average surveyor cost x number of hours for the survey process.

These fees shall be submitted at the time of the application for federal certification and
shall not be refunded. All fees collected after the date that the imposition of fees is not
prohibited by federal law shall be deposited in the state treasury and credited to the state
government special revenue fund.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 2.

new text begin [144I.01] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin For the purposes of this chapter, the definitions in this
section have the meanings given.
new text end

new text begin Subd. 2. new text end

new text begin Adult. new text end

new text begin "Adult" means a natural person who has attained the age of 18 years.
new text end

new text begin Subd. 3. new text end

new text begin Advanced practice registered nurse. new text end

new text begin "Advanced practice registered nurse"
has the meaning given in section 148.171, subdivision 3.
new text end

new text begin Subd. 4. new text end

new text begin Applicant. new text end

new text begin "Applicant" means an individual, legal entity, or other organization
that has applied for licensure under this chapter.
new text end

new text begin Subd. 5. new text end

new text begin Assisted living contract. new text end

new text begin "Assisted living contract" means the legal agreement
between a resident and an assisted living facility for housing and, if applicable, assisted
living services.
new text end

new text begin Subd. 6. new text end

new text begin Assisted living director. new text end

new text begin "Assisted living director" means a person who
administers, manages, supervises, or is in general administrative charge of an assisted living
facility, whether or not the individual has an ownership interest in the facility, and whether
or not the person's functions or duties are shared with one or more individuals and who is
licensed by the Board of Executives for Long Term Services and Supports pursuant to
section 144A.20.
new text end

new text begin Subd. 7. new text end

new text begin Assisted living facility. new text end

new text begin "Assisted living facility" means a licensed facility that
provides sleeping accommodations and assisted living services to one or more adults.
Assisted living facility includes assisted living facility with dementia care, and does not
include:
new text end

new text begin (1) emergency shelter, transitional housing, or any other residential units serving
exclusively or primarily homeless individuals, as defined under section 116L.361;
new text end

new text begin (2) a nursing home licensed under chapter 144A;
new text end

new text begin (3) a hospital, certified boarding care, or supervised living facility licensed under sections
144.50 to 144.56;
new text end

new text begin (4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts
9520.0500 to 9520.0670, or under chapter 245D or 245G;
new text end

new text begin (5) services and residential settings licensed under chapter 245A, including adult foster
care and services and settings governed under the standards in chapter 245D;
new text end

new text begin (6) a private home in which the residents are related by kinship, law, or affinity with the
provider of services;
new text end

new text begin (7) a duly organized condominium, cooperative, and common interest community, or
owners' association of the condominium, cooperative, and common interest community
where at least 80 percent of the units that comprise the condominium, cooperative, or
common interest community are occupied by individuals who are the owners, members, or
shareholders of the units;
new text end

new text begin (8) a temporary family health care dwelling as defined in sections 394.307 and 462.3593;
new text end

new text begin (9) a setting offering services conducted by and for the adherents of any recognized
church or religious denomination for its members exclusively through spiritual means or
by prayer for healing;
new text end

new text begin (10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with
low-income housing tax credits pursuant to United States Code, title 26, section 42, and
units financed by the Minnesota Housing Finance Agency that are intended to serve
individuals with disabilities or individuals who are homeless, except for those developments
that market or hold themselves out as assisted living facilities and provide assisted living
services;
new text end

new text begin (11) rental housing developed under United States Code, title 42, section 1437, or United
States Code, title 12, section 1701q;
new text end

new text begin (12) rental housing designated for occupancy by only elderly or elderly and disabled
residents under United States Code, title 42, section 1437e, or rental housing for qualifying
families under Code of Federal Regulations, title 24, section 983.56;
new text end

new text begin (13) rental housing funded under United States Code, title 42, chapter 89, or United
States Code, title 42, section 8011; or
new text end

new text begin (14) an independent senior living facility governed by chapter 144K.
new text end

new text begin Subd. 8. new text end

new text begin Assisted living facility with dementia care. new text end

new text begin "Assisted living facility with
dementia care" means a licensed assisted living facility that is advertised, marketed, or
otherwise promoted as providing specialized care for individuals with Alzheimer's disease
or other dementias. An assisted living facility with a secured dementia care unit must be
licensed as an assisted living facility with dementia care.
new text end

new text begin Subd. 9. new text end

new text begin Assisted living services. new text end

new text begin "Assisted living services" includes one or more of
the following:
new text end

new text begin (1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, and bathing;
new text end

new text begin (2) providing standby assistance;
new text end

new text begin (3) providing verbal or visual reminders to the resident to take regularly scheduled
medication, which includes bringing the resident previously set up medication, medication
in original containers, or liquid or food to accompany the medication;
new text end

new text begin (4) providing verbal or visual reminders to the resident to perform regularly scheduled
treatments and exercises;
new text end

new text begin (5) preparing modified diets ordered by a licensed health professional;
new text end

new text begin (6) services of an advanced practice registered nurse, registered nurse, licensed practical
nurse, physical therapist, respiratory therapist, occupational therapist, speech-language
pathologist, dietitian or nutritionist, or social worker;
new text end

new text begin (7) tasks delegated to unlicensed personnel by a registered nurse or assigned by a licensed
health professional within the person's scope of practice;
new text end

new text begin (8) medication management services;
new text end

new text begin (9) hands-on assistance with transfers and mobility;
new text end

new text begin (10) treatment and therapies;
new text end

new text begin (11) assisting residents with eating when the residents have complicated eating problems
as identified in the resident record or through an assessment such as difficulty swallowing,
recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
instruments to be fed;
new text end

new text begin (12) providing other complex or specialty health care services;
new text end

new text begin (13) "I'm okay" check services; and
new text end

new text begin (14) supportive services in addition to the provision of at least one of the services listed
in clauses (1) to (12).
new text end

new text begin Subd. 10. new text end

new text begin Authority having jurisdiction. new text end

new text begin "Authority having jurisdiction" means an
organization, office, or individual responsible for enforcing the requirements of a code or
standard, or for approving equipment, materials, an installation, or a procedure.
new text end

new text begin Subd. 11. new text end

new text begin Authorized agent. new text end

new text begin "Authorized agent" means the person who is authorized
to accept service of notices and orders on behalf of the licensee.
new text end

new text begin Subd. 12. new text end

new text begin Change of ownership. new text end

new text begin "Change of ownership" means a change in the licensee
that is responsible for the management, control, and operation of a facility.
new text end

new text begin Subd. 13. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of health.
new text end

new text begin Subd. 14. new text end

new text begin Controlled substance. new text end

new text begin "Controlled substance" has the meaning given in
section 152.01, subdivision 4.
new text end

new text begin Subd. 15. new text end

new text begin Controlling individual. new text end

new text begin (a) "Controlling individual" means an owner and the
following individuals and entities, if applicable:
new text end

new text begin (1) each officer of the organization, including the chief executive officer and chief
financial officer;
new text end

new text begin (2) each managerial official; and
new text end

new text begin (3) any entity with at least a five percent mortgage, deed of trust, or other security interest
in the facility.
new text end

new text begin (b) Controlling individual does not include:
new text end

new text begin (1) a bank, savings bank, trust company, savings association, credit union, industrial
loan and thrift company, investment banking firm, or insurance company unless the entity
operates a program directly or through a subsidiary;
new text end

new text begin (2) government and government-sponsored entities such as the U.S. Department of
Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the Minnesota
Housing Finance Agency which provide loans, financing, and insurance products for housing
sites;
new text end

new text begin (3) an individual who is a state or federal official, a state or federal employee, or a
member or employee of the governing body of a political subdivision of the state or federal
government that operates one or more facilities, unless the individual is also an officer,
owner, or managerial official of the facility, receives remuneration from the facility, or
owns any of the beneficial interests not excluded in this subdivision;
new text end

new text begin (4) an individual who owns less than five percent of the outstanding common shares of
a corporation:
new text end

new text begin (i) whose securities are exempt under section 80A.45, clause (6); or
new text end

new text begin (ii) whose transactions are exempt under section 80A.46, clause (2);
new text end

new text begin (5) an individual who is a member of an organization exempt from taxation under section
290.05, unless the individual is also an officer, owner, or managerial official of the license
or owns any of the beneficial interests not excluded in this subdivision. This clause does
not exclude from the definition of controlling individual an organization that is exempt from
taxation; or
new text end

new text begin (6) an employee stock ownership plan trust, or a participant or board member of an
employee stock ownership plan, unless the participant or board member is a controlling
individual.
new text end

new text begin Subd. 16. new text end

new text begin Dementia. new text end

new text begin "Dementia" means the loss of cognitive function, including the
ability to think, remember, problem solve, or reason, of sufficient severity to interfere with
an individual's daily functioning. Dementia is caused by different diseases and conditions,
including but not limited to Alzheimer's disease, vascular dementia, neurodegenerative
conditions, Creutzfeldt-Jakob disease, and Huntington's disease.
new text end

new text begin Subd. 17. new text end

new text begin Dementia care services. new text end

new text begin "Dementia care services" means ongoing care for
behavioral and psychological symptoms of dementia, including planned group and individual
programming and person-centered care practices provided according to section 144I.40 to
support activities of daily living for people living with dementia.
new text end

new text begin Subd. 18. new text end

new text begin Dementia-trained staff. new text end

new text begin "Dementia-trained staff" means any employee who
has completed the minimum training required under sections 144I.21 and 144I.39 and has
demonstrated knowledge and the ability to support individuals with dementia.
new text end

new text begin Subd. 19. new text end

new text begin Designated representative. new text end

new text begin "Designated representative" means a person
designated in writing by the resident in an assisted living contract and identified in the
resident record on file with the facility.
new text end

new text begin Subd. 20. new text end

new text begin Dietary supplement. new text end

new text begin "Dietary supplement" means a product taken by mouth
that contains a dietary ingredient intended to supplement the diet. Dietary ingredients may
include vitamins, minerals, herbs or other botanicals, amino acids, and substances such as
enzymes, organ tissue, glandulars, or metabolites.
new text end

new text begin Subd. 21. new text end

new text begin Dietitian. new text end

new text begin "Dietitian" means a person licensed as a dietitian under section
148.624.
new text end

new text begin Subd. 22. new text end

new text begin Direct contact. new text end

new text begin "Direct contact" means providing face-to-face care, training,
supervision, counseling, consultation, or medication assistance to residents of a facility.
new text end

new text begin Subd. 23. new text end

new text begin Direct ownership interest. new text end

new text begin "Direct ownership interest" means an individual
or organization with the possession of at least five percent equity in capital, stock, or profits
of the licensee, or who is a member of a limited liability company of the licensee.
new text end

new text begin Subd. 24. new text end

new text begin Facility. new text end

new text begin "Facility" means an assisted living facility.
new text end

new text begin Subd. 25. new text end

new text begin Hands-on assistance. new text end

new text begin "Hands-on assistance" means physical help by another
person without which the resident is not able to perform the activity.
new text end

new text begin Subd. 26. new text end

new text begin "I'm okay" check services. new text end

new text begin ""I'm okay" check services" means having,
maintaining, and documenting a system to, by any means, check on the health, safety, and
well-being of a resident a minimum of once daily or more frequently according to the assisted
living contract.
new text end

new text begin Subd. 27. new text end

new text begin Indirect ownership interest. new text end

new text begin "Indirect ownership interest" means an individual
or legal entity with a direct ownership interest in an entity that has a direct or indirect
ownership interest of at least five percent in an entity that is a licensee.
new text end

new text begin Subd. 28. new text end

new text begin Legal representative. new text end

new text begin "Legal representative" means one of the following in
the order of priority listed, to the extent the person may reasonably be identified and located:
new text end

new text begin (1) a court-appointed guardian acting in accordance with the powers granted to the
guardian under chapter 524;
new text end

new text begin (2) a conservator acting in accordance with the powers granted to the conservator under
chapter 524;
new text end

new text begin (3) a health care agent acting in accordance with the powers granted to the health care
agent under chapter 145C; or
new text end

new text begin (4) an attorney-in-fact acting in accordance with the powers granted to the attorney-in-fact
by a written power of attorney under chapter 523.
new text end

new text begin Subd. 29. new text end

new text begin Licensed health professional. new text end

new text begin "Licensed health professional" means a person
licensed in Minnesota to practice a profession described in section 214.01, subdivision 2.
new text end

new text begin Subd. 30. new text end

new text begin Licensed practical nurse. new text end

new text begin "Licensed practical nurse" has the meaning given
in section 148.171, subdivision 8.
new text end

new text begin Subd. 31. new text end

new text begin Licensed resident capacity. new text end

new text begin "Licensed resident capacity" means the resident
occupancy level requested by a licensee and approved by the commissioner.
new text end

new text begin Subd. 32. new text end

new text begin Licensee. new text end

new text begin "Licensee" means a person or legal entity to whom the commissioner
issues a license for an assisted living facility and who is responsible for the management,
control, and operation of a facility.
new text end

new text begin Subd. 33. new text end

new text begin Maltreatment. new text end

new text begin "Maltreatment" means conduct described in section 626.5572,
subdivision 15.
new text end

new text begin Subd. 34. new text end

new text begin Management agreement. new text end

new text begin "Management agreement" means a written, executed
agreement between a licensee and manager regarding the provision of certain services on
behalf of the licensee.
new text end

new text begin Subd. 35. new text end

new text begin Manager. new text end

new text begin "Manager" means an individual or legal entity designated by the
licensee through a management agreement to act on behalf of the licensee in the on-site
management of the assisted living facility.
new text end

new text begin Subd. 36. new text end

new text begin Managerial official. new text end

new text begin "Managerial official" means an individual who has the
decision-making authority related to the operation of the facility and the responsibility for
the ongoing management or direction of the policies, services, or employees of the facility.
new text end

new text begin Subd. 37. new text end

new text begin Medication. new text end

new text begin "Medication" means a prescription or over-the-counter drug. For
purposes of this chapter only, medication includes dietary supplements.
new text end

new text begin Subd. 38. new text end

new text begin Medication administration. new text end

new text begin "Medication administration" means performing
a set of tasks that includes the following:
new text end

new text begin (1) checking the resident's medication record;
new text end

new text begin (2) preparing the medication as necessary;
new text end

new text begin (3) administering the medication to the resident;
new text end

new text begin (4) documenting the administration or reason for not administering the medication; and
new text end

new text begin (5) reporting to a registered nurse or appropriate licensed health professional any concerns
about the medication, the resident, or the resident's refusal to take the medication.
new text end

new text begin Subd. 39. new text end

new text begin Medication management. new text end

new text begin "Medication management" means the provision
of any of the following medication-related services to a resident:
new text end

new text begin (1) performing medication setup;
new text end

new text begin (2) administering medications;
new text end

new text begin (3) storing and securing medications;
new text end

new text begin (4) documenting medication activities;
new text end

new text begin (5) verifying and monitoring the effectiveness of systems to ensure safe handling and
administration;
new text end

new text begin (6) coordinating refills;
new text end

new text begin (7) handling and implementing changes to prescriptions;
new text end

new text begin (8) communicating with the pharmacy about the resident's medications; and
new text end

new text begin (9) coordinating and communicating with the prescriber.
new text end

new text begin Subd. 40. new text end

new text begin Medication reconciliation. new text end

new text begin "Medication reconciliation" means the process
of identifying the most accurate list of all medications the resident is taking, including the
name, dosage, frequency, and route, by comparing the resident record to an external list of
medications obtained from the resident, hospital, prescriber, or other provider.
new text end

new text begin Subd. 41. new text end

new text begin Medication setup. new text end

new text begin "Medication setup" means arranging medications by a
nurse, pharmacy, or authorized prescriber for later administration by the resident or by
facility staff.
new text end

new text begin Subd. 42. new text end

new text begin New construction. new text end

new text begin "New construction" means a new building, renovation,
modification, reconstruction, physical changes altering the use of occupancy, or addition
to a building.
new text end

new text begin Subd. 43. new text end

new text begin Nurse. new text end

new text begin "Nurse" means a person who is licensed under sections 148.171 to
148.285.
new text end

new text begin Subd. 44. new text end

new text begin Nutritionist. new text end

new text begin "Nutritionist" means a person licensed as a nutritionist under
section 148.624.
new text end

new text begin Subd. 45. new text end

new text begin Occupational therapist. new text end

new text begin "Occupational therapist" means a person who is
licensed under sections 148.6401 to 148.6449.
new text end

new text begin Subd. 46. new text end

new text begin Ombudsman. new text end

new text begin "Ombudsman" means the ombudsman for long-term care.
new text end

new text begin Subd. 47. new text end

new text begin Over-the-counter drug. new text end

new text begin "Over-the-counter drug" means a drug that is not
required by federal law to bear the symbol "Rx only."
new text end

new text begin Subd. 48. new text end

new text begin Owner. new text end

new text begin "Owner" means an individual or legal entity that has a direct or indirect
ownership interest of five percent or more in a licensee. For purposes of this chapter, "owner
of a nonprofit corporation" means the president and treasurer of the board of directors or,
for an entity owned by an employee stock ownership plan, means the president and treasurer
of the entity. A government entity that is issued a license under this chapter shall be
designated the owner.
new text end

new text begin Subd. 49. new text end

new text begin Person-centered planning and service delivery. new text end

new text begin "Person-centered planning
and service delivery" means services as defined in section 245D.07, subdivision 1a, paragraph
(b).
new text end

new text begin Subd. 50. new text end

new text begin Pharmacist. new text end

new text begin "Pharmacist" has the meaning given in section 151.01, subdivision
3.
new text end

new text begin Subd. 51. new text end

new text begin Physical therapist. new text end

new text begin "Physical therapist" means a person who is licensed under
sections 148.65 to 148.78.
new text end

new text begin Subd. 52. new text end

new text begin Physician. new text end

new text begin "Physician" means a person who is licensed under chapter 147.
new text end

new text begin Subd. 53. new text end

new text begin Prescriber. new text end

new text begin "Prescriber" means a person who is authorized by section 148.235;
151.01, subdivision 23; or 151.37 to prescribe prescription drugs.
new text end

new text begin Subd. 54. new text end

new text begin Prescription. new text end

new text begin "Prescription" has the meaning given in section 151.01,
subdivision 16a.
new text end

new text begin Subd. 55. new text end

new text begin Provisional license. new text end

new text begin "Provisional license" means the initial license the
commissioner issues after approval of a complete written application and before the
commissioner completes the provisional license survey and determines that the provisional
licensee is in substantial compliance.
new text end

new text begin Subd. 56. new text end

new text begin Regularly scheduled. new text end

new text begin "Regularly scheduled" means ordered or planned to be
completed at predetermined times or according to a predetermined routine.
new text end

new text begin Subd. 57. new text end

new text begin Reminder. new text end

new text begin "Reminder" means providing a verbal or visual reminder to a
resident.
new text end

new text begin Subd. 58. new text end

new text begin Repeat violation. new text end

new text begin "Repeat violation" means the issuance of two or more
correction orders within a 12-month period for a violation of the same provision of a statute
or rule.
new text end

new text begin Subd. 59. new text end

new text begin Resident. new text end

new text begin "Resident" means a person living in an assisted living facility who
has executed an assisted living contract.
new text end

new text begin Subd. 60. new text end

new text begin Resident record. new text end

new text begin "Resident record" means all records that document
information about the services provided to the resident.
new text end

new text begin Subd. 61. new text end

new text begin Respiratory therapist. new text end

new text begin "Respiratory therapist" means a person who is licensed
under chapter 147C.
new text end

new text begin Subd. 62. new text end

new text begin Secured dementia care unit. new text end

new text begin "Secured dementia care unit" means a designated
area or setting designed for individuals with dementia that is locked or secured to prevent
a resident from exiting, or to limit a resident's ability to exit, the secured area or setting. A
secured dementia care unit is not solely an individual resident's living area.
new text end

new text begin Subd. 63. new text end

new text begin Service plan. new text end

new text begin "Service plan" means the written plan between the resident or
the resident's representative and the provisional licensee or licensee about the services that
will be provided to the resident.
new text end

new text begin Subd. 64. new text end

new text begin Social worker. new text end

new text begin "Social worker" means a person who is licensed under chapter
148D or 148E.
new text end

new text begin Subd. 65. new text end

new text begin Speech-language pathologist. new text end

new text begin "Speech-language pathologist" has the meaning
given in section 148.512, subdivision 17.
new text end

new text begin Subd. 66. new text end

new text begin Standby assistance. new text end

new text begin "Standby assistance" means the presence of another
person within arm's reach to minimize the risk of injury while performing daily activities
through physical intervention or cueing to assist a resident with an assistive task by providing
cues, oversight, and minimal physical assistance.
new text end

new text begin Subd. 67. new text end

new text begin Substantial compliance. new text end

new text begin "Substantial compliance" means complying with
the requirements in this chapter sufficiently to prevent unacceptable health or safety risks
to residents.
new text end

new text begin Subd. 68. new text end

new text begin Supportive services. new text end

new text begin "Supportive services" means:
new text end

new text begin (1) assistance with laundry, shopping, and household chores;
new text end

new text begin (2) housekeeping services;
new text end

new text begin (3) provision or assistance with meals or food preparation;
new text end

new text begin (4) help with arranging for, or arranging transportation to, medical, social, recreational,
personal, or social services appointments; or
new text end

new text begin (5) provision of social or recreational services.
new text end

new text begin Arranging for services does not include making referrals, or contacting a service provider
in an emergency.
new text end

new text begin Subd. 69. new text end

new text begin Survey. new text end

new text begin "Survey" means an inspection of a licensee or applicant for licensure
for compliance with this chapter and applicable rules.
new text end

new text begin Subd. 70. new text end

new text begin Surveyor. new text end

new text begin "Surveyor" means a staff person of the department who is authorized
to conduct surveys of assisted living facilities.
new text end

new text begin Subd. 71. new text end

new text begin Termination of housing or services. new text end

new text begin "Termination of housing or services"
means a discharge, eviction, transfer, or service termination initiated by the facility. A
facility-initiated termination is one to which the resident objects and which did not originate
through a resident's verbal or written request. A resident-initiated termination is one where
a resident or, if appropriate, a designated representative provided a verbal or written notice
of intent to leave the facility. A resident-initiated termination does not include the general
expression of a desire to return home or the elopement of a resident with cognitive
impairment.
new text end

new text begin Subd. 72. new text end

new text begin Treatment or therapy. new text end

new text begin "Treatment" or "therapy" means the provision of care,
other than medications, ordered or prescribed by a licensed health professional and provided
to a resident to cure, rehabilitate, or ease symptoms.
new text end

new text begin Subd. 73. new text end

new text begin Unit of government. new text end

new text begin "Unit of government" means a city, county, town, school
district, other political subdivision of the state, or agency of the state or federal government,
that includes any instrumentality of a unit of government.
new text end

new text begin Subd. 74. new text end

new text begin Unlicensed personnel. new text end

new text begin "Unlicensed personnel" means individuals not otherwise
licensed or certified by a governmental health board or agency who provide services to a
resident.
new text end

new text begin Subd. 75. new text end

new text begin Verbal. new text end

new text begin "Verbal" means oral and not in writing.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 3.

new text begin [144I.02] ASSISTED LIVING FACILITY LICENSE.
new text end

new text begin Subdivision 1. new text end

new text begin License required. new text end

new text begin Beginning August 1, 2021, no assisted living facility
may operate in Minnesota unless it is licensed under this chapter. The licensee is legally
responsible for the management, control, and operation of the facility, regardless of the
existence of a management agreement or subcontract. Nothing in this chapter shall in any
way affect the rights and remedies available under other law.
new text end

new text begin Subd. 2. new text end

new text begin Licensure categories. new text end

new text begin (a) The categories in this subdivision are established for
assisted living facility licensure.
new text end

new text begin (b) The assisted living facility category is for assisted living facilities that only provide
assisted living services.
new text end

new text begin (c) The assisted living facility with dementia care category is for assisted living facilities
that provide assisted living services and dementia care services. An assisted living facility
with dementia care may also provide dementia care services in a secured dementia care
unit.
new text end

new text begin (d) An assisted living facility that has a secured dementia care unit must be licensed as
an assisted living facility with dementia care.
new text end

new text begin Subd. 3. new text end

new text begin Licensure under other law. new text end

new text begin An assisted living facility licensed under this
chapter is not required to also be licensed as a boarding establishment, food and beverage
service establishment, hotel, motel, lodging establishment, resort, or restaurant under chapter
157.
new text end

new text begin Subd. 4. new text end

new text begin Violations; penalty. new text end

new text begin (a) Operating an assisted living facility without a license
is a misdemeanor punishable by a fine imposed by the commissioner.
new text end

new text begin (b) A controlling individual of the facility in violation of this section is guilty of a
misdemeanor. This paragraph shall not apply to any controlling individual who had no legal
authority to affect or change decisions related to the operation of the facility.
new text end

new text begin (c) The sanctions in this section do not restrict other available sanctions in law.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 4.

new text begin [144I.03] PROVISIONAL LICENSE.
new text end

new text begin Subdivision 1. new text end

new text begin Provisional license. new text end

new text begin Beginning August 1, 2021, for new assisted living
facility license applicants, the commissioner shall issue a provisional license from one of
the licensure categories specified in section 144I.02, subdivision 2. A provisional license
is effective for up to one year from the initial effective date of the license, except that a
provisional license may be extended according to subdivision 2, paragraphs (c) and (d).
new text end

new text begin Subd. 2. new text end

new text begin Initial survey; licensure. new text end

new text begin (a) During the provisional license period, the
commissioner shall survey the provisional licensee after the commissioner is notified or
has evidence that the provisional licensee is providing assisted living services to at least
one resident.
new text end

new text begin (b) Within two days of beginning to provide assisted living services, the provisional
licensee must provide notice to the commissioner that it is providing assisted living services
by sending an e-mail to the e-mail address provided by the commissioner. If the provisional
licensee does not provide services during the provisional license period, the provisional
license shall expire at the end of the period and the applicant must reapply.
new text end

new text begin (c) If the provisional licensee notifies the commissioner that the licensee is providing
assisted living services within 45 calendar days prior to expiration of the provisional license,
the commissioner may extend the provisional license for up to 60 calendar days in order to
allow the commissioner to complete the on-site survey required under this section and
follow-up survey visits.
new text end

new text begin (d) If the provisional licensee is in substantial compliance with the survey, the
commissioner shall issue a facility license. If the provisional licensee is not in substantial
compliance with the initial survey, the commissioner shall either: (1) not issue the facility
license and terminate the provisional license; or (2) extend the provisional license for a
period not to exceed 90 calendar days and apply conditions necessary to bring the facility
into substantial compliance. If the provisional licensee is not in substantial compliance with
the survey within the time period of the extension or if the provisional licensee does not
satisfy the license conditions, the commissioner may deny the license.
new text end

new text begin Subd. 3. new text end

new text begin Reconsideration. new text end

new text begin (a) If a provisional licensee whose assisted living facility
license has been denied or extended with conditions disagrees with the conclusions of the
commissioner, then the provisional licensee may request a reconsideration by the
commissioner. The reconsideration request process must be conducted internally by the
commissioner and chapter 14 does not apply.
new text end

new text begin (b) The provisional licensee requesting the reconsideration must make the request in
writing and must list and describe the reasons why the provisional licensee disagrees with
the decision to deny the facility license or the decision to extend the provisional license
with conditions.
new text end

new text begin (c) The reconsideration request and supporting documentation must be received by the
commissioner within 15 calendar days after the date the provisional licensee receives the
denial or provisional license with conditions.
new text end

new text begin Subd. 4. new text end

new text begin Continued operation. new text end

new text begin A provisional licensee whose license is denied is
permitted to continue operating during the period of time when:
new text end

new text begin (1) a reconsideration is in process;
new text end

new text begin (2) an extension of the provisional license and terms associated with it is in active
negotiation between the commissioner and the licensee and the commissioner confirms the
negotiation is active; or
new text end

new text begin (3) a transfer of residents to a new facility is underway and not all of the residents have
relocated.
new text end

new text begin Subd. 5. new text end

new text begin Requirements for notice and transfer. new text end

new text begin A provisional licensee whose license
is denied must comply with the requirements for notification and transfer of residents in
section 144J.08.
new text end

new text begin Subd. 6. new text end

new text begin Fines. new text end

new text begin The fee for failure to comply with the notification requirements in section
144J.08, subdivision 6, paragraph (b), is $1,000.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 5.

new text begin [144I.04] APPLICATION FOR LICENSURE.
new text end

new text begin Subdivision 1. new text end

new text begin License applications. new text end

new text begin (a) Each application for an assisted living facility
license, including provisional and renewal applications, must include information sufficient
to show that the applicant meets the requirements of licensure, including:
new text end

new text begin (1) the business name and legal entity name of the licensee, and the street address and
mailing address of the facility;
new text end

new text begin (2) the names, e-mail addresses, telephone numbers, and mailing addresses of all owners,
controlling individuals, managerial officials, and the assisted living director;
new text end

new text begin (3) the name and e-mail address of the managing agent and manager, if applicable;
new text end

new text begin (4) the licensed resident capacity and the license category;
new text end

new text begin (5) the license fee in the amount specified in section 144.122;
new text end

new text begin (6) documentation of compliance with the background study requirements in section
144I.06 for the owner, controlling individuals, and managerial officials. Each application
for a new license must include documentation for the applicant and for each individual with
five percent or more direct or indirect ownership in the applicant;
new text end

new text begin (7) evidence of workers' compensation coverage as required by sections 176.181 and
176.182;
new text end

new text begin (8) documentation that the facility has liability coverage;
new text end

new text begin (9) a copy of the executed lease agreement between the landlord and the licensee, if
applicable;
new text end

new text begin (10) a copy of the management agreement, if applicable;
new text end

new text begin (11) a copy of the operations transfer agreement or similar agreement, if applicable;
new text end

new text begin (12) an organizational chart that identifies all organizations and individuals with an
ownership interest in the licensee of five percent or greater and that specifies their relationship
with the licensee and with each other;
new text end

new text begin (13) whether the applicant, owner, controlling individual, managerial official, or assisted
living director of the facility has ever been convicted of:
new text end

new text begin (i) a crime or found civilly liable for a federal or state felony level offense that was
detrimental to the best interests of the facility and its resident within the last ten years
preceding submission of the license application. Offenses include: felony crimes against
persons and other similar crimes for which the individual was convicted, including guilty
pleas and adjudicated pretrial diversions; financial crimes such as extortion, embezzlement,
income tax evasion,, insurance fraud, and other similar crimes for which the individual was
convicted, including guilty pleas and adjudicated pretrial diversions; any felonies involving
malpractice that resulted in a conviction of criminal neglect or misconduct; and any felonies
that would result in a mandatory exclusion under section 1128(a) of the Social Security
Act;.
new text end

new text begin (ii) any misdemeanor conviction, under federal or state law, related to: the delivery of
an item or service under Medicaid or a state health care program, or the abuse or neglect of
a patient in connection with the delivery of a health care item or service;
new text end

new text begin (iii) any misdemeanor conviction, under federal or state law, related to theft, fraud,
embezzlement, breach of fiduciary duty, or other financial misconduct in connection with
the delivery of a health care item or service;
new text end

new text begin (iv) any felony or misdemeanor conviction, under federal or state law, relating to the
interference with or obstruction of any investigation into any criminal offense described in
Code of Federal Regulations, title 42, section 1001.101 or 1001.201;
new text end

new text begin (v) any felony or misdemeanor conviction, under federal or state law, relating to the
unlawful manufacture, distribution, prescription, or dispensing of a controlled substance;
new text end

new text begin (vi) any felony or gross misdemeanor that relates to the operation of a nursing home or
assisted living facility or directly affects resident safety or care during that period;
new text end

new text begin (vii) any revocation or suspension of a license to provide health care by any state licensing
authority. This includes the surrender of such a license while a formal disciplinary proceeding
was pending before a state licensing authority;
new text end

new text begin (viii) any revocation or suspension of accreditation; or
new text end

new text begin (ix) any suspension or exclusion from participation in, or any sanction imposed by, a
federal or state health care program, or any debarment from participation in any federal
executive branch procurement or non-procurement program;
new text end

new text begin (14) whether, in the preceding three years, the applicant or any owner, controlling
individual, managerial official, or assisted living director of the facility has a record of
defaulting in the payment of money collected for others, including the discharge of debts
through bankruptcy proceedings;
new text end

new text begin (15) the signature of the owner of the licensee, or an authorized agent of the licensee;
new text end

new text begin (16) identification of all states where the applicant or individual having a five percent
or more ownership, currently or previously has been licensed as an owner or operator of a
long-term care, community-based, or health care facility or agency where its license or
federal certification has been denied, suspended, restricted, conditioned, refused, not renewed,
or revoked under a private or state-controlled receivership, or where these same actions are
pending under the laws of any state or federal authority;
new text end

new text begin (17) statistical information required by the commissioner; and
new text end

new text begin (18) any other information required by the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Authorized agents. new text end

new text begin (a) An application for an assisted living facility license or
for renewal of a facility license must specify one or more owners, controlling individuals,
or employees as authorized agents who can accept service on behalf of the licensee in
proceedings under this chapter.
new text end

new text begin (b) Notwithstanding any law to the contrary, personal service on the authorized agent
named in the application is deemed to be service on all of the controlling individuals or
managerial officials of the facility, and it is not a defense to any action arising under this
chapter that personal service was not made on each controlling individual or managerial
official of the facility. The designation of one or more controlling individuals or managerial
officials under this subdivision shall not affect the legal responsibility of any other controlling
individual or managerial official under this chapter.
new text end

new text begin Subd. 3. new text end

new text begin Fees. new text end

new text begin (a) An initial applicant, renewal applicant, or applicant filing a change
of ownership for assisted living facility licensure must submit the application fee required
in section 144.122 to the commissioner along with a completed application.
new text end

new text begin (b) The penalty for late submission of the renewal application less than 30 days before
the expiration date of the license or after expiration of the license is $200. The penalty for
operating a facility after expiration of the license and before a renewal license is issued, is
$250 each day after expiration of the license until the renewal license issuance date. The
facility is still subject to the misdemeanor penalties for operating after license expiration.
new text end

new text begin (c) Fees collected under this section shall be deposited in the state treasury and credited
to the state government special revenue fund. All fees are nonrefundable.
new text end

new text begin (d) Fines collected under this subdivision shall be deposited in a dedicated special revenue
account. On an annual basis, the balance in the special revenue account shall be appropriated
to the commissioner to implement the recommendations of the advisory council established
in section 144A.4799.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 6.

new text begin [144I.05] TRANSFER OF LICENSE PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Transfers prohibited. new text end

new text begin An assisted living facility license may not be
transferred to another party.
new text end

new text begin Subd. 2. new text end

new text begin New license required. new text end

new text begin (a) A prospective licensee must apply for a license prior
to operating a currently licensed assisted living facility. The new license, if issued, shall
not be a provisional license. The licensee must change whenever one of the following events
occur:
new text end

new text begin (1) the form of the licensee's legal entity structure is converted or changed to a different
type of legal entity structure;
new text end

new text begin (2) the licensee dissolves, consolidates, or merges with another legal organization and
the licensee's legal organization does not survive;
new text end

new text begin (3) within the previous 24 months, 50 percent or more of the licensee is transferred,
whether by a single transaction or multiple transactions, to:
new text end

new text begin (i) a different person; or
new text end

new text begin (ii) a person who had less than a five percent ownership interest in the facility at the
time of the first transaction; or
new text end

new text begin (4) any other event or combination of events that results in a substitution, elimination,
or withdrawal of the licensee's responsibility for the facility.
new text end

new text begin (b) The prospective licensee must provide written notice to the department at least 60
calendar days prior to the anticipated date of the change of licensee.
new text end

new text begin Subd. 3. new text end

new text begin Survey required. new text end

new text begin For all new licensees after a change of ownership, the
commissioner shall complete a survey within six months after the new license is issued.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 7.

new text begin [144I.06] BACKGROUND STUDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Background studies required. new text end

new text begin (a) Before the commissioner issues a
provisional license, issues a license as a result of an approved change of ownership, or
renews a license, a managerial official or a natural person who is an owner with direct
ownership interest is required to undergo a background study under section 144.057. No
person may be involved in the management, operation, or control of an assisted living facility
if the person has been disqualified under chapter 245C. For the purposes of this section,
managerial officials subject to the background study requirement are individuals who provide
direct contact.
new text end

new text begin (b) The commissioner shall not issue a license if any controlling individual, including
a managerial official, has been unsuccessful in having a background study disqualification
set aside under section 144.057 and chapter 245C.
new text end

new text begin (c) Employees, contractors, and regularly-scheduled volunteers of the facility are subject
to the background study required by section 144.057 and may be disqualified under chapter
245C. Nothing in this section shall be construed to prohibit the facility from requiring
self-disclosure of criminal conviction information.
new text end

new text begin Subd. 2. new text end

new text begin Reconsideration. new text end

new text begin If an individual is disqualified under section 144.057 or
chapter 245C, the individual may request reconsideration of the disqualification. If the
individual requests reconsideration and the commissioner sets aside or rescinds the
disqualification, the individual is eligible to be involved in the management, operation, or
control of the facility. If an individual has a disqualification under section 245C.15,
subdivision 1, and the disqualification is affirmed, the individual's disqualification is barred
from a set aside, and the individual must not be involved in the management, operation, or
control of the facility.
new text end

new text begin Subd. 3. new text end

new text begin Data classification. new text end

new text begin Data collected under this section shall be classified as
private data on individuals under section 13.02, subdivision 12.
new text end

new text begin Subd. 4. new text end

new text begin Termination in good faith. new text end

new text begin Termination of an employee in good faith reliance
on information or records obtained under this section regarding a confirmed conviction does
not subject the assisted living facility to civil liability or liability for unemployment benefits.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 8.

new text begin [144I.07] LICENSE RENEWAL.
new text end

new text begin A license that is not a provisional license may be renewed for a period of up to one year
if the licensee:
new text end

new text begin (1) submits an application for renewal in the format provided by the commissioner at
least 60 calendar days before expiration of the license;
new text end

new text begin (2) submits the renewal fee under section 144I.04, subdivision 3;
new text end

new text begin (3) submits the late fee under section 144I.04, subdivision 3, if the renewal application
is received less than 30 days before the expiration date of the license or after the expiration
of the license;
new text end

new text begin (4) provides information sufficient to show that the applicant meets the requirements of
licensure, including items required under section 144I.04, subdivision 1; and
new text end

new text begin (5) provides any other information deemed necessary by the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 9.

new text begin [144I.08] NOTIFICATION OF CHANGES IN INFORMATION.
new text end

new text begin A provisional licensee or licensee shall notify the commissioner in writing prior to a
change in the manager or authorized agent and within 60 calendar days after any change in
the information required in section 144I.04, subdivision 1, paragraph (a), clause (1), (3),
(4), (17), or (18).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 10.

new text begin [144I.09] CONSIDERATION OF APPLICATIONS.
new text end

new text begin (a) Before issuing a provisional license or license or renewing a license, the commissioner
shall consider an applicant's compliance history in providing care in a facility that provides
care to children, the elderly, ill individuals, or individuals with disabilities.
new text end

new text begin (b) The applicant's compliance history shall include repeat violation, rule violations, and
any license or certification involuntarily suspended or terminated during an enforcement
process.
new text end

new text begin (c) The commissioner may deny, revoke, suspend, restrict, or refuse to renew the license
or impose conditions if:
new text end

new text begin (1) the applicant fails to provide complete and accurate information on the application
and the commissioner concludes that the missing or corrected information is needed to
determine if a license shall be granted;
new text end

new text begin (2) the applicant, knowingly or with reason to know, made a false statement of a material
fact in an application for the license or any data attached to the application or in any matter
under investigation by the department;
new text end

new text begin (3) the applicant refused to allow agents of the commissioner to inspect its books, records,
and files related to the license application, or any portion of the premises;
new text end

new text begin (4) the applicant willfully prevented, interfered with, or attempted to impede in any way:
(i) the work of any authorized representative of the commissioner, the ombudsman for
long-term care, or the ombudsman for mental health and developmental disabilities; or (ii)
the duties of the commissioner, local law enforcement, city or county attorneys, adult
protection, county case managers, or other local government personnel;
new text end

new text begin (5) the applicant has a history of noncompliance with federal or state regulations that
were detrimental to the health, welfare, or safety of a resident or a client; or
new text end

new text begin (6) the applicant violates any requirement in this chapter.
new text end

new text begin (e) If a license is denied, the applicant has the reconsideration rights available under
section 144I.03, subdivision 3.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 11.

new text begin [144I.10] MINIMUM ASSISTED LIVING FACILITY REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Minimum requirements. new text end

new text begin (a) All assisted living facilities shall:
new text end

new text begin (1) distribute to residents, families, and resident representatives the assisted living bill
of rights;
new text end

new text begin (2) provide services in a manner that complies with the Nurse Practice Act in sections
148.171 to 148.285;
new text end

new text begin (3) utilize a person-centered planning and service delivery process;
new text end

new text begin (4) have and maintain a system for delegation of health care activities to unlicensed
personnel by a registered nurse, including supervision and evaluation of the delegated
activities as required by the Nurse Practice Act in sections 148.171 to 148.285;
new text end

new text begin (5) provide a means for residents to request assistance for health and safety needs 24
hours per day, seven days per week;
new text end

new text begin (6) allow residents the ability to furnish and decorate the resident's unit within the terms
of the assisted living contract;
new text end

new text begin (7) permit residents access to food at any time;
new text end

new text begin (8) allow residents to choose the resident's visitors and times of visits;
new text end

new text begin (9) allow the resident the right to choose a roommate if sharing a unit;
new text end

new text begin (10) notify the resident of the resident's right to have and use a lockable door to the
resident's unit. The licensee shall provide the locks on the unit. Only a staff member with
a specific need to enter the unit shall have keys, and advance notice must be given to the
resident before entrance, when possible. An assisted living facility must not lock a resident
in the resident's unit;
new text end

new text begin (11) develop and implement a staffing plan for determining its staffing level that:
new text end

new text begin (i) includes an evaluation, to be conducted at least twice a year, of the appropriateness
of staffing levels in the facility;
new text end

new text begin (ii) ensures sufficient staffing at all times to meet the scheduled and reasonably
foreseeable unscheduled needs of each resident as required by the residents' assessments
and service plans on a 24-hour per day basis; and
new text end

new text begin (iii) ensures that the facility can respond promptly and effectively to individual resident
emergencies and to emergency, life safety, and disaster situations affecting staff or residents
in the facility;
new text end

new text begin (12) ensures that one or more persons are available 24 hours per day, seven days per
week, who are responsible for responding to the requests of residents for assistance with
health or safety needs. Such persons must be:
new text end

new text begin (i) awake;
new text end

new text begin (ii) located in the same building, in an attached building, or on a contiguous campus
with the facility in order to respond within a reasonable amount of time;
new text end

new text begin (iii) capable of communicating with residents;
new text end

new text begin (iv) capable of providing or summoning the appropriate assistance;
new text end

new text begin (v) capable of following directions; and
new text end

new text begin (vi) for an assisted living facility with dementia care providing services in a secured
dementia care unit, an awake person must be physically present in the secured dementia
care unit;
new text end

new text begin (13) offer to provide or make available at least the following services to residents:
new text end

new text begin (i) at least three nutritious meals daily with snacks available seven days per week,
according to the recommended dietary allowances in the United States Department of
Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables. The
following apply:
new text end

new text begin (A) menus must be prepared at least one week in advance, and made available to all
residents. The facility must encourage residents' involvement in menu planning. Meal
substitutions must be of similar nutritional value if a resident refuses a food that is served.
Residents must be informed in advance of menu changes;
new text end

new text begin (B) food must be prepared and served according to the Minnesota Food Code, Minnesota
Rules, chapter 4626; and
new text end

new text begin (C) the facility cannot require a resident to include and pay for meals in their contract;
new text end

new text begin (ii) weekly housekeeping;
new text end

new text begin (iii) weekly laundry service;
new text end

new text begin (iv) upon the request of the resident, provide direct or reasonable assistance with arranging
for transportation to medical and social services appointments, shopping, and other recreation,
and provide the name of or other identifying information about the persons responsible for
providing this assistance;
new text end

new text begin (v) upon the request of the resident, provide reasonable assistance with accessing
community resources and social services available in the community, and provide the name
of or other identifying information about persons responsible for providing this assistance;
new text end

new text begin (vi) provide culturally sensitive programs; and
new text end

new text begin (vii) have a daily program of social and recreational activities that are based upon
individual and group interests, physical, mental, and psychosocial needs, and that creates
opportunities for active participation in the community at large.
new text end

new text begin (b) The resident's rights in section 144I.101, subdivisions 12, 13, and 18, may be restricted
for an individual resident only if determined necessary for health and safety reasons identified
by the facility through an initial assessment or reassessment under section 144I.16,
subdivision 2, and documented in the written service plan under section 144I.16, subdivision
4. Any restrictions of those rights for people served under sections 256B.0915 and 256B.49
must be documented by the case manager in the resident's coordinated service and support
plan (CSSP), as defined in sections 256B.0915, subdivision 6, and 256B.49, subdivision
15. Nothing in this section affects other laws applicable to or prohibiting restrictions on the
resident's rights in section 144I.101, subdivisions 12, 13, and 18.
new text end

new text begin Subd. 2. new text end

new text begin Policies and procedures. new text end

new text begin (a) Each assisted living facility must have policies
and procedures in place to address the following and keep them current:
new text end

new text begin (1) requirements in section 626.557, reporting of maltreatment of vulnerable adults;
new text end

new text begin (2) conducting and handling background studies on employees;
new text end

new text begin (3) orientation, training, and competency evaluations of staff, and a process for evaluating
staff performance;
new text end

new text begin (4) handling complaints from residents, family members, or designated representatives
regarding staff or services provided by staff;
new text end

new text begin (5) conducting initial evaluations of residents' needs and the providers' ability to provide
those services;
new text end

new text begin (6) conducting initial and ongoing resident evaluations and assessments of resident
needs, including assessments by a registered nurse or appropriate licensed health professional,
and how changes in a resident's condition are identified, managed, and communicated to
staff and other health care providers as appropriate;
new text end

new text begin (7) orientation to and implementation of the assisted living bill of rights;
new text end

new text begin (8) infection control practices;
new text end

new text begin (9) reminders for medications, treatments, or exercises, if provided;
new text end

new text begin (10) conducting appropriate screenings, or documentation of prior screenings, to show
that staff are free of tuberculosis, consistent with current United States Centers for Disease
Control and Prevention standards;
new text end

new text begin (11) ensuring that nurses and licensed health professionals have current and valid licenses
to practice;
new text end

new text begin (12) medication and treatment management;
new text end

new text begin (13) delegation of tasks by registered nurses or licensed health professionals;
new text end

new text begin (14) supervision of registered nurses and licensed health professionals; and
new text end

new text begin (15) supervision of unlicensed personnel performing delegated tasks.
new text end

new text begin Subd. 3. new text end

new text begin Infection control program. new text end

new text begin All assisted living facilities must establish and
maintain an infection control program.
new text end

new text begin Subd. 4. new text end

new text begin Clinical nurse supervision. new text end

new text begin All assisted living facilities must have a clinical
nurse supervisor who is a registered nurse licensed in Minnesota.
new text end

new text begin Subd. 5. new text end

new text begin Resident councils. new text end

new text begin The facility must provide a resident council with space and
privacy for meetings, where doing so is reasonably achievable. Staff, visitors, and other
guests may attend a resident council meeting only at the council's invitation. The facility
must designate a staff person who is approved by the resident council to be responsible for
providing assistance and responding to written requests that result from meetings. The
facility must consider the views of the resident council and must respond promptly to the
grievances and recommendations of the council, but a facility is not required to implement
as recommended every request of the council. The facility shall, with the approval of the
resident council, take reasonably achievable steps to make residents aware of upcoming
meetings in a timely manner.
new text end

new text begin Subd. 6. new text end

new text begin Family councils. new text end

new text begin The facility must provide a family council with space and
privacy for meetings, where doing so is reasonably achievable. The facility must designate
a staff person who is approved by the family council to be responsible for providing
assistance and responding to written requests that result from meetings. The facility must
consider the views of the family council and must respond promptly to the grievances and
recommendations of the council, but a facility is not required to implement as recommended
every request of the council. The facility shall, with the approval of the family council, take
reasonably achievable steps to make residents and family members aware of upcoming
meetings in a timely manner.
new text end

new text begin Subd. 7. new text end

new text begin Resident grievances; reporting maltreatment. new text end

new text begin All facilities must post in a
conspicuous place information about the facilities' grievance procedure, and the name,
telephone number, and e-mail contact information for the individuals who are responsible
for handling resident grievances. The notice must also have the contact information for the
state and applicable regional Office of Ombudsman for Long-Term Care and the Office of
Ombudsman for Mental Health and Developmental Disabilities, and must have information
for reporting suspected maltreatment to the Minnesota Adult Abuse Reporting Center.
new text end

new text begin Subd. 8. new text end

new text begin Protecting resident rights. new text end

new text begin All facilities shall ensure that every resident has
access to consumer advocacy or legal services by:
new text end

new text begin (1) providing names and contact information, including telephone numbers and e-mail
addresses of at least three organizations that provide advocacy or legal services to residents;
new text end

new text begin (2) providing the name and contact information for the Minnesota Office of Ombudsman
for Long-Term Care and the Office of the Ombudsman for Mental Health and Developmental
Disabilities, including both the state and regional contact information;
new text end

new text begin (3) assisting residents in obtaining information on whether Medicare or medical assistance
under chapter 256B will pay for services;
new text end

new text begin (4) making reasonable accommodations for people who have communication disabilities
and those who speak a language other than English; and
new text end

new text begin (5) providing all information and notices in plain language and in terms the residents
can understand.
new text end

new text begin Subd. 9. new text end

new text begin Payment for services under disability waivers. new text end

new text begin For new assisted living
facilities that did not operate as registered housing with services establishments prior to
August 1, 2021, home and community-based services under section 256B.49 are not available
when the new facility setting is adjoined to, or on the same property as, an institution as
defined in Code of Federal Regulations, title 42, section 441.301(c).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 12.

new text begin [144I.101] ASSISTED LIVING BILL OF RIGHTS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin This section applies to residents living in assisted living
facilities.
new text end

new text begin Subd. 2. new text end

new text begin Legislative intent. new text end

new text begin The rights established under this section for the benefit of
residents do not limit any other rights available under law. No facility may request or require
that any resident waive any of these rights at any time for any reason, including as a condition
of admission to the facility.
new text end

new text begin Subd. 3. new text end

new text begin Information about rights. new text end

new text begin Before receiving services, residents have the right
to be informed by the facility of the rights granted under this section and the recourse
residents have if rights are violated. The information must be in plain language and in terms
residents can understand. The facility must make reasonable accommodations for residents
who have communication disabilities and those who speak a language other than English.
new text end

new text begin Subd. 4. new text end

new text begin Appropriate care and services. new text end

new text begin (a) Residents have the right to care and assisted
living services that are appropriate based on the resident's needs and according to an
up-to-date service plan subject to accepted health care standards.
new text end

new text begin (b) Residents have the right to receive health care and other assisted living services with
continuity from people who are properly trained and competent to perform their duties and
in sufficient numbers to adequately provide the services agreed to in the assisted living
contract and the service plan.
new text end

new text begin Subd. 5. new text end

new text begin Refusal of care or services. new text end

new text begin Residents have the right to refuse care or assisted
living services and to be informed by the facility of the medical, health-related, or
psychological consequences of refusing care or services.
new text end

new text begin Subd. 6. new text end

new text begin Participation in care and service planning. new text end

new text begin Residents have the right to actively
participate in the planning, modification, and evaluation of their care and services. This
right includes:
new text end

new text begin (1) the opportunity to discuss care, services, treatment, and alternatives with the
appropriate caregivers;
new text end

new text begin (2) the right to include a family member or the resident's health care agent and designated
representative, or both; and
new text end

new text begin (3) the right to be told in advance of, and take an active part in decisions regarding, any
recommended changes in the service plan.
new text end

new text begin Subd. 7. new text end

new text begin Courteous treatment. new text end

new text begin Residents have the right to be treated with courtesy and
respect, and to have the resident's property treated with respect.
new text end

new text begin Subd. 8. new text end

new text begin Freedom from maltreatment. new text end

new text begin Residents have the right to be free from physical,
sexual, and emotional abuse; neglect; financial exploitation; and all forms of maltreatment
covered under the Vulnerable Adults Act.
new text end

new text begin Subd. 9. new text end

new text begin Right to come and go freely. new text end

new text begin Residents have the right to enter and leave the
facility as they choose. This right may be restricted only as allowed by other law and
consistent with a resident's service plan.
new text end

new text begin Subd. 10. new text end

new text begin Individual autonomy. new text end

new text begin Residents have the right to individual autonomy,
initiative, and independence in making life choices, including establishing a daily schedule
and choosing with whom to interact.
new text end

new text begin Subd. 11. new text end

new text begin Right to control resources. new text end

new text begin Residents have the right to control personal
resources.
new text end

new text begin Subd. 12. new text end

new text begin Visitors and social participation. new text end

new text begin (a) Residents have the right to meet with
or receive visits at any time by the resident's family, guardian, conservator, health care
agent, attorney, advocate, or religious or social work counselor, or any person of the resident's
choosing. This right may be restricted in certain circumstances if necessary for the resident's
health and safety and if documented in the resident's service plan.
new text end

new text begin (b) Residents have the right to engage in community life and in activities of their choice.
This includes the right to participate in commercial, religious, social, community, and
political activities without interference and at their discretion if the activities do not infringe
on the rights of other residents.
new text end

new text begin Subd. 13. new text end

new text begin Personal and treatment privacy. new text end

new text begin (a) Residents have the right to consideration
of their privacy, individuality, and cultural identity as related to their social, religious, and
psychological well-being. Staff must respect the privacy of a resident's space by knocking
on the door and seeking consent before entering, except in an emergency or where clearly
inadvisable or unless otherwise documented in the resident's service plan.
new text end

new text begin (b) Residents have the right to have and use a lockable door to the resident's unit. The
facility shall provide locks on the resident's unit. Only a staff member with a specific need
to enter the unit shall have keys. This right may be restricted in certain circumstances if
necessary for a resident's health and safety and documented in the resident's service plan.
new text end

new text begin (c) Residents have the right to respect and privacy regarding the resident's service plan.
Case discussion, consultation, examination, and treatment are confidential and must be
conducted discreetly. Privacy must be respected during toileting, bathing, and other activities
of personal hygiene, except as needed for resident safety or assistance.
new text end

new text begin Subd. 14. new text end

new text begin Communication privacy. new text end

new text begin (a) Residents have the right to communicate
privately with persons of their choice.
new text end

new text begin (b) If an assisted living facility is sending or receiving mail on behalf of residents, the
assisted living facility must do so without interference.
new text end

new text begin (c) Residents must be provided access to a telephone to make and receive calls.
new text end

new text begin Subd. 15. new text end

new text begin Confidentiality of records. new text end

new text begin (a) Residents have the right to have personal,
financial, health, and medical information kept private, to approve or refuse release of
information to any outside party, and to be advised of the assisted living facility's policies
and procedures regarding disclosure of the information. Residents must be notified when
personal records are requested by any outside party.
new text end

new text begin (b) Residents have the right to access their own records.
new text end

new text begin Subd. 16. new text end

new text begin Right to furnish and decorate. new text end

new text begin Residents have the right to furnish and decorate
the resident's unit within the terms of the assisted living contract.
new text end

new text begin Subd. 17. new text end

new text begin Right to choose roommate. new text end

new text begin Residents have the right to choose a roommate
if sharing a unit.
new text end

new text begin Subd. 18. new text end

new text begin Right to access food. new text end

new text begin Residents have the right to access food at any time.
This right may be restricted in certain circumstances if necessary for the resident's health
and safety and if documented in the resident's service plan.
new text end

new text begin Subd. 19. new text end

new text begin Access to technology. new text end

new text begin Residents have the right to access Internet service at
their expense.
new text end

new text begin Subd. 20. new text end

new text begin Grievances and inquiries. new text end

new text begin Residents have the right to make and receive a
timely response to a complaint or inquiry, without limitation. Residents have the right to
know and every facility must provide the name and contact information of the person
representing the facility who is designated to handle and resolve complaints and inquiries.
new text end

new text begin Subd. 21. new text end

new text begin Access to counsel and advocacy services. new text end

new text begin Residents have the right to the
immediate access by:
new text end

new text begin (1) the resident's legal counsel;
new text end

new text begin (2) any representative of the protection and advocacy system designated by the state
under Code of Federal Regulations, title 45, section 1326.21; or
new text end

new text begin (3) any representative of the Office of Ombudsman for Long-Term Care.
new text end

new text begin Subd. 22. new text end

new text begin Information about charges. new text end

new text begin Before services are initiated, residents have the
right to be notified:
new text end

new text begin (1) of all charges for housing and assisted living services;
new text end

new text begin (2) of any limits on housing and assisted living services available;
new text end

new text begin (3) if known, whether and what amount of payment may be expected from health
insurance, public programs, or other sources; and
new text end

new text begin (4) what charges the resident may be responsible for paying.
new text end

new text begin Subd. 23. new text end

new text begin Information about individuals providing services. new text end

new text begin Before receiving services
identified in the service plan, residents have the right to be told the type and disciplines of
staff who will be providing the services, the frequency of visits proposed to be furnished,
and other choices that are available for addressing the resident's needs.
new text end

new text begin Subd. 24. new text end

new text begin Information about other providers and services. new text end

new text begin Residents have the right
to be informed by the assisted living facility, prior to executing an assisted living contract,
that other public and private services may be available and that the resident has the right to
purchase, contract for, or obtain services from a provider other than the assisted living
facility.
new text end

new text begin Subd. 25. new text end

new text begin Resident councils. new text end

new text begin Residents have the right to organize and participate in
resident councils as described in section 144I.10, subdivision 5.
new text end

new text begin Subd. 26. new text end

new text begin Family councils. new text end

new text begin Residents have the right to participate in family councils
formed by families or residents as described in section 144I.10, subdivision 6.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 13.

new text begin [144I.11] HOUSING AND SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Responsibility for housing and services. new text end

new text begin The facility is directly
responsible to the resident for all housing and service-related matters provided, irrespective
of a management contract. Housing and service-related matters include but are not limited
to the handling of complaints, the provision of notices, and the initiation of any adverse
action against the resident involving housing or services provided by the facility.
new text end

new text begin Subd. 2. new text end

new text begin Uniform checklist disclosure of services. new text end

new text begin (a) On and after August 1, 2021, all
assisted living facilities must provide to prospective residents, the prospective resident's
legal and designated representatives, and any other person or persons the resident chooses:
new text end

new text begin (1) a disclosure of the categories of assisted living licenses available and the category
of license held by the facility;
new text end

new text begin (2) a written checklist listing all services permitted under the facility's license, identifying
all services the facility offers to provide under the assisted living facility contract, and
identifying all services allowed under the license that the facility does not provide; and
new text end

new text begin (2) an oral explanation of the services offered under the contract.
new text end

new text begin (b) The requirements of paragraph (a) must be completed prior to the execution of the
assisted living contract.
new text end

new text begin (c) The commissioner must, in consultation with all interested stakeholders, design the
uniform checklist disclosure form for use as provided under paragraph (a).
new text end

new text begin Subd. 3. new text end

new text begin Reservation of rights. new text end

new text begin Nothing in this chapter:
new text end

new text begin (1) requires a resident to utilize any service provided by or through, or made available
in, a facility;
new text end

new text begin (2) prevents a facility from requiring, as a condition of the contract, that the resident pay
for a package of services even if the resident does not choose to use all or some of the
services in the package. For residents who are eligible for home and community-based
waiver services under sections 256B.0915 and 256B.49, payment for services will follow
the policies of those programs;
new text end

new text begin (3) requires a facility to fundamentally alter the nature of the operations of the facility
in order to accommodate a resident's request; or
new text end

new text begin (4) affects the duty of a facility to grant a resident's request for reasonable
accommodations.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 14.

new text begin [144I.12] TRANSFER OF RESIDENTS WITHIN FACILITY.
new text end

new text begin Subdivision 1. new text end

new text begin Transfers. new text end

new text begin (a) All assisted living facilities must provide for the safe,
orderly, and appropriate transfer of residents within the facility.
new text end

new text begin (b) If an assisted living contract permits resident transfers within a facility, the facility
must comply with the notice requirements in subdivision 2.
new text end

new text begin (c) In situations where there is a curtailment, reduction, capital improvement, or change
in operations within a facility, the facility must minimize the number of transfers needed
to complete the project or change in operations, consider individual resident needs and
preferences, and provide reasonable accommodation for individual resident requests regarding
the room transfer. The facility must provide notice to the Office of Ombudsman for
Long-Term Care and, when appropriate, the Office of Ombudsman for Mental Health and
Developmental Disabilities in advance of any notice to residents, residents' legal and
designated representatives, and families when all of the following circumstances apply:
new text end

new text begin (1) the transfers of residents within the facility are being proposed due to curtailment,
reduction, capital improvements, or change in operations;
new text end

new text begin (2) the transfers of residents within the facility are not temporary moves to accommodate
physical plan upgrades or renovation; and
new text end

new text begin (3) the transfers involve multiple residents being moved simultaneously.
new text end

new text begin Subd. 2. new text end

new text begin Notice required before transfer within facility. new text end

new text begin (a) A facility must:
new text end

new text begin (1) notify a resident and the resident's legal and designated representatives, if any, at
least 30 calendar days prior to a proposed nonemergency transfer within the facility; and
new text end

new text begin (2) obtain consent from the resident or the resident's legal or designated representative,
if any.
new text end

new text begin (b) A resident must be allowed to stay in the resident's room. If a resident consents to a
move, any needed reasonable modifications must be made to the new room to accommodate
the resident's disabilities.
new text end

new text begin Subd. 3. new text end

new text begin Evaluation. new text end

new text begin A facility shall evaluate the resident's individual needs before
deciding whether the room to which the resident will be moved fits the resident's
psychological, cognitive, and health care needs, including the accessibility of the bathroom.
new text end

new text begin Subd. 4. new text end

new text begin Restriction on transfer. new text end

new text begin A person who has been a private-pay resident for at
least one year and resides in a private room, and whose payments subsequently will be made
under the medical assistance program under chapter 256B, may not be relocated to a shared
room without the consent of the resident or the resident's legal or designated representative,
if any.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 15.

new text begin [144I.13] BUSINESS OPERATION.
new text end

new text begin Subdivision 1. new text end

new text begin Display of license. new text end

new text begin The original current license must be displayed at the
main entrance of each assisted living facility. The facility must provide a copy of the license
to any person who requests it.
new text end

new text begin Subd. 2. new text end

new text begin Quality management. new text end

new text begin The facility shall engage in quality management
appropriate to the size of the facility and relevant to the type of services provided. The
quality management activity means evaluating the quality of care by periodically reviewing
resident services, complaints made, and other issues that have occurred and determining
whether changes in services, staffing, or other procedures need to be made in order to ensure
safe and competent services to residents. Documentation about quality management activity
must be available for two years. Information about quality management must be available
to the commissioner at the time of the survey, investigation, or renewal.
new text end

new text begin Subd. 3. new text end

new text begin Facility restrictions. new text end

new text begin (a) This subdivision does not apply to licensees that are
Minnesota counties or other units of government.
new text end

new text begin (b) A facility or staff person may not:
new text end

new text begin (1) accept a power-of-attorney from residents for any purpose, and may not accept
appointments as guardians or conservators of residents; or
new text end

new text begin (2) borrow a resident's funds or personal or real property, nor in any way convert a
resident's property to the possession of the facility or staff person.
new text end

new text begin (c) A facility may not serve as a resident's legal, designated, or other representative.
new text end

new text begin (d) Nothing in this subdivision precludes a facility or staff person from accepting gifts
of minimal value or precludes acceptance of donations or bequests made to a facility that
are exempt from section 501(c)(3) of the Internal Revenue Code.
new text end

new text begin Subd. 4. new text end

new text begin Handling residents' finances and property. new text end

new text begin (a) A facility may assist residents
with household budgeting, including paying bills and purchasing household goods, but may
not otherwise manage a resident's property.
new text end

new text begin (b) Where funds are deposited with the facility by the resident, the licensee:
new text end

new text begin (1) retains fiduciary and custodial responsibility for the funds;
new text end

new text begin (2) is directly accountable to the resident for the funds; and
new text end

new text begin (3) must maintain records of and provide a resident with receipts for all transactions and
purchases made with the resident's funds. When receipts are not available, the transaction
or purchase must be documented.
new text end

new text begin (c) Subject to paragraph (d), if responsibilities for day-to-day management of the resident
funds are delegated to the manager, the manager must:
new text end

new text begin (1) provide the licensee with a monthly accounting of the resident funds; and
new text end

new text begin (2) meet all legal requirements related to holding and accounting for resident funds.
new text end

new text begin (d) The facility must ensure any party responsible for holding or managing residents'
personal funds is bonded or obtains insurance in sufficient amounts to specifically cover
losses of resident funds and provides proof of the bond or insurance.
new text end

new text begin Subd. 5. new text end

new text begin Final accounting; return of money and property. new text end

new text begin Within 30 days of the
effective date of a facility-initiated or resident-initiated termination of housing or services
or the death of the resident, the facility must:
new text end

new text begin (1) provide to the resident, resident's legal representative, and resident's designated
representative a final statement of account;
new text end

new text begin (2) provide any refunds due;
new text end

new text begin (3) return any money, property, or valuables held in trust or custody by the facility; and
new text end

new text begin (4) as required under section 504B.178, refund the resident's security deposit unless it
is applied to the first month's charges.
new text end

new text begin Subd. 6. new text end

new text begin Compliance with requirements for reporting maltreatment of vulnerable
adults; abuse prevention plan. new text end

new text begin (a) The assisted living facility must comply with the
requirements for the reporting of maltreatment of vulnerable adults in section 626.557. The
facility must establish and implement a written procedure to ensure that all cases of suspected
maltreatment are reported.
new text end

new text begin (b) The facility must develop and implement an individual abuse prevention plan for
each vulnerable adult. The plan shall contain an individualized review or assessment of the
person's susceptibility to abuse by another individual, including other vulnerable adults; the
person's risk of abusing other vulnerable adults; and statements of the specific measures to
be taken to minimize the risk of abuse to that person and other vulnerable adults. For purposes
of the abuse prevention plan, abuse includes self-abuse.
new text end

new text begin Subd. 7. new text end

new text begin Posting information for reporting suspected crime and maltreatment. new text end

new text begin The
facility shall support protection and safety through access to the state's systems for reporting
suspected criminal activity and suspected vulnerable adult maltreatment by:
new text end

new text begin (1) posting the 911 emergency number in common areas and near telephones provided
by the assisted living facility;
new text end

new text begin (2) posting information and the reporting number for the Minnesota Adult Abuse
Reporting Center to report suspected maltreatment of a vulnerable adult under section
626.557; and
new text end

new text begin (3) providing reasonable accommodations with information and notices in plain language.
new text end

new text begin Subd. 8. new text end

new text begin Employee records. new text end

new text begin (a) The facility must maintain current records of each paid
employee, each regularly scheduled volunteer providing services, and each individual
contractor providing services. The records must include the following information:
new text end

new text begin (1) evidence of current professional licensure, registration, or certification if licensure,
registration, or certification is required by this chapter or rules;
new text end

new text begin (2) records of orientation, required annual training and infection control training, and
competency evaluations;
new text end

new text begin (3) current job description, including qualifications, responsibilities, and identification
of staff persons providing supervision;
new text end

new text begin (4) documentation of annual performance reviews that identify areas of improvement
needed and training needs;
new text end

new text begin (5) for individuals providing assisted living services, verification that required health
screenings under subdivision 9, have taken place and the dates of those screenings; and
new text end

new text begin (6) documentation of the background study as required under section 144.057.
new text end

new text begin (b) Each employee record must be retained for at least three years after a paid employee,
volunteer, or contractor ceases to be employed by, provide services at, or be under contract
with the facility. If a facility ceases operation, employee records must be maintained for
three years after facility operations cease.
new text end

new text begin Subd. 9. new text end

new text begin Tuberculosis prevention and control. new text end

new text begin The facility must establish and maintain
a comprehensive tuberculosis infection control program according to the most current
tuberculosis infection control guidelines issued by the United States Centers for Disease
Control and Prevention (CDC), Division of Tuberculosis Elimination, as published in the
CDC's Morbidity and Mortality Weekly Report (MMWR). The program must include a
tuberculosis infection control plan that covers all paid and unpaid employees, contractors,
students, and regularly scheduled volunteers. The commissioner shall provide technical
assistance regarding implementation of the guidelines.
new text end

new text begin Subd. 10. new text end

new text begin Disaster planning and emergency preparedness plan. new text end

new text begin (a) The facility must
meet the following requirements:
new text end

new text begin (1) have a written emergency disaster plan that contains a plan for evacuation, addresses
elements of sheltering in place, identifies temporary relocation sites, and details staff
assignments in the event of a disaster or an emergency;
new text end

new text begin (2) post an emergency disaster plan prominently;
new text end

new text begin (3) provide building emergency exit diagrams to all residents;
new text end

new text begin (4) post emergency exit diagrams on each floor; and
new text end

new text begin (5) have a written policy and procedure regarding missing tenant residents.
new text end

new text begin (b) The facility must provide emergency and disaster training to all staff during the initial
staff orientation and annually thereafter and must make emergency and disaster training
annually available to all residents. Staff who have not received emergency and disaster
training are allowed to work only when trained staff are also working on site.
new text end

new text begin (c) The facility must meet any additional requirements adopted in rule.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 16.

new text begin [144I.14] STAFFING AND SUPERVISORY REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Qualifications, training, and competency. new text end

new text begin All staff persons providing
assisted living services must be trained and competent in the provision of services consistent
with current practice standards appropriate to the resident's needs, and promote and be
trained to support the assisted living bill of rights.
new text end

new text begin Subd. 2. new text end

new text begin Licensed health professionals and nurses. new text end

new text begin (a) Licensed health professionals
and nurses providing services as employees of a licensed facility must possess a current
Minnesota license or registration to practice.
new text end

new text begin (b) Licensed health professionals and registered nurses must be competent in assessing
resident needs, planning appropriate services to meet resident needs, implementing services,
and supervising staff if assigned.
new text end

new text begin (c) Nothing in this section limits or expands the rights of nurses or licensed health
professionals to provide services within the scope of their licenses or registrations, as
provided by law.
new text end

new text begin Subd. 3. new text end

new text begin Unlicensed personnel. new text end

new text begin (a) Unlicensed personnel providing assisted living
services must have:
new text end

new text begin (1) successfully completed a training and competency evaluation appropriate to the
services provided by the facility and the topics listed in subdivision 10, paragraph (b); or
new text end

new text begin (2) demonstrated competency by satisfactorily completing a written or oral test on the
tasks the unlicensed personnel will perform and on the topics listed in subdivision 10,
paragraph (b); and successfully demonstrated competency of topics in subdivision 10,
paragraph (b), clauses (5), (7), and (8), by a practical skills test.
new text end

new text begin Unlicensed personnel who only provide assisted living services listed in section 144I.01,
subdivision 9, clauses (1) to (5), shall not perform delegated nursing or therapy tasks.
new text end

new text begin (b) Unlicensed personnel performing delegated nursing tasks in an assisted living facility
must:
new text end

new text begin (1) have successfully completed training and demonstrated competency by successfully
completing a written or oral test of the topics in subdivision 10, paragraphs (b) and (c), and
a practical skills test on tasks listed in subdivision 10, paragraphs (b), clauses (5) and (7),
and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform;
new text end

new text begin (2) satisfy the current requirements of Medicare for training or competency of home
health aides or nursing assistants, as provided by Code of Federal Regulations, title 42,
section 483 or 484.36; or
new text end

new text begin (3) have, before April 19, 1993, completed a training course for nursing assistants that
was approved by the commissioner.
new text end

new text begin (c) Unlicensed personnel performing therapy or treatment tasks delegated or assigned
by a licensed health professional must meet the requirements for delegated tasks in
subdivision 7 and any other training or competency requirements within the licensed health
professional's scope of practice relating to delegation or assignment of tasks to unlicensed
personnel.
new text end

new text begin Subd. 4. new text end

new text begin Availability of contact person to staff. new text end

new text begin (a) Assisted living facilities must have
a registered nurse available for consultation to staff performing delegated nursing tasks and
must have an appropriate licensed health professional available if performing other delegated
services such as therapies.
new text end

new text begin (b) The appropriate contact person must be readily available either in person, by
telephone, or by other means to the staff at times when the staff is providing services.
new text end

new text begin Subd. 5. new text end

new text begin Supervision of staff. new text end

new text begin (a) Staff who only provide assisted living services specified
in section 144I.01, subdivision 9, clauses (1) to (5), must be supervised periodically where
the services are being provided to verify that the work is being performed competently and
to identify problems and solutions to address issues relating to the staff's ability to provide
the services. The supervision of the unlicensed personnel must be done by staff of the facility
having the authority, skills, and ability to provide the supervision of unlicensed personnel
and who can implement changes as needed, and train staff.
new text end

new text begin (b) Supervision includes direct observation of unlicensed personnel while the unlicensed
personnel are providing the services and may also include indirect methods of gaining input
such as gathering feedback from the resident. Supervisory review of staff must be provided
at a frequency based on the staff person's competency and performance.
new text end

new text begin Subd. 6. new text end

new text begin Supervision of staff providing delegated nursing or therapy tasks. new text end

new text begin (a) Staff
who perform delegated nursing or therapy tasks must be supervised by an appropriate
licensed health professional or a registered nurse according to the assisted living facility's
policy where the services are being provided to verify that the work is being performed
competently and to identify problems and solutions related to the staff person's ability to
perform the tasks. Supervision of staff performing medication or treatment administration
shall be provided by a registered nurse or appropriate licensed health professional and must
include observation of the staff administering the medication or treatment and the interaction
with the resident.
new text end

new text begin (b) The direct supervision of staff performing delegated tasks must be provided within
30 calendar days after the date on which the individual begins working for the facility and
first performs the delegated tasks for residents and thereafter as needed based on performance.
This requirement also applies to staff who have not performed delegated tasks for one year
or longer.
new text end

new text begin Subd. 7. new text end

new text begin Delegation of assisted living services. new text end

new text begin A registered nurse or licensed health
professional may delegate tasks only to staff who are competent and possess the knowledge
and skills consistent with the complexity of the tasks and according to the appropriate
Minnesota practice act. The assisted living facility must establish and implement a system
to communicate up-to-date information to the registered nurse or licensed health professional
regarding the current available staff and their competency so the registered nurse or licensed
health professional has sufficient information to determine the appropriateness of delegating
tasks to meet individual resident needs and preferences.
new text end

new text begin Subd. 8. new text end

new text begin Documentation. new text end

new text begin A facility must retain documentation of supervision activities
in the personnel records.
new text end

new text begin Subd. 9. new text end

new text begin Temporary staff. new text end

new text begin When a facility contracts with a temporary staffing agency,
those individuals must meet the same requirements required by this section for personnel
employed by the facility and shall be treated as if they are staff of the facility.
new text end

new text begin Subd. 10. new text end

new text begin Instructor and competency evaluation requirements; training for
unlicensed personnel. new text end

new text begin (a) Instructors and competency evaluators must meet the following
requirements:
new text end

new text begin (1) training and competency evaluations of unlicensed personnel who only provide
assisted living services specified in section 144I.01, subdivision 9, clauses (1) to (5), must
be conducted by individuals with work experience and training in providing these services;
and
new text end

new text begin (2) training and competency evaluations of unlicensed personnel providing assisted
living services must be conducted by a registered nurse, or another instructor may provide
training in conjunction with the registered nurse.
new text end

new text begin (b) Training and competency evaluations for all unlicensed personnel must include the
following:
new text end

new text begin (1) documentation requirements for all services provided;
new text end

new text begin (2) reports of changes in the resident's condition to the supervisor designated by the
facility;
new text end

new text begin (3) basic infection control, including blood-borne pathogens;
new text end

new text begin (4) maintenance of a clean and safe environment;
new text end

new text begin (5) appropriate and safe techniques in personal hygiene and grooming, including:
new text end

new text begin (i) hair care and bathing;
new text end

new text begin (ii) care of teeth, gums, and oral prosthetic devices;
new text end

new text begin (iii) care and use of hearing aids; and
new text end

new text begin (iv) dressing and assisting with toileting;
new text end

new text begin (6) training on the prevention of falls;
new text end

new text begin (7) standby assistance techniques and how to perform them;
new text end

new text begin (8) medication, exercise, and treatment reminders;
new text end

new text begin (9) basic nutrition, meal preparation, food safety, and assistance with eating;
new text end

new text begin (10) preparation of modified diets as ordered by a licensed health professional;
new text end

new text begin (11) communication skills that include preserving the dignity of the resident and showing
respect for the resident and the resident's preferences, cultural background, and family;
new text end

new text begin (12) awareness of confidentiality and privacy;
new text end

new text begin (13) understanding appropriate boundaries between staff and residents and the resident's
family;
new text end

new text begin (14) procedures to use in handling various emergency situations; and
new text end

new text begin (15) awareness of commonly used health technology equipment and assistive devices.
new text end

new text begin (c) In addition to paragraph (b), training and competency evaluation for unlicensed
personnel providing assisted living services must include:
new text end

new text begin (1) observing, reporting, and documenting resident status;
new text end

new text begin (2) basic knowledge of body functioning and changes in body functioning, injuries, or
other observed changes that must be reported to appropriate personnel;
new text end

new text begin (3) reading and recording temperature, pulse, and respirations of the resident;
new text end

new text begin (4) recognizing physical, emotional, cognitive, and developmental needs of the resident;
new text end

new text begin (5) safe transfer techniques and ambulation;
new text end

new text begin (6) range of motioning and positioning; and
new text end

new text begin (7) administering medications or treatments as required.
new text end

new text begin (d) When the registered nurse or licensed health professional delegates tasks, that person
must ensure that prior to the delegation the unlicensed personnel is trained in the proper
methods to perform the tasks or procedures for each resident and are able to demonstrate
the ability to competently follow the procedures and perform the tasks. If an unlicensed
personnel has not regularly performed the delegated assisted living task for a period of 24
consecutive months, the unlicensed personnel must demonstrate competency in the task to
the registered nurse or appropriate licensed health professional. The registered nurse or
licensed health professional must document instructions for the delegated tasks in the
resident's record.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 17.

new text begin [144I.15] REQUIRED NOTICES.
new text end

new text begin Subdivision 1. new text end

new text begin Assisted living bill of rights; notification to resident. new text end

new text begin (a) An assisted
living facility must provide the resident, legal representative, and designated representative
a written notice of the rights under section 144I.101 before the initiation of services to that
resident. The facility shall make all reasonable efforts to provide notice of the rights to the
resident and the legal and designated representatives in a language the resident and legal
and designated representatives can understand.
new text end

new text begin (b) In addition to the text of the assisted living bill of rights in section 144I.101, the
notice shall also contain the following statement describing how to file a complaint or report
suspected abuse.
new text end

new text begin "If you want to report suspected abuse, neglect, or financial exploitation, you may contact
the Minnesota Adult Abuse Reporting Center (MAARC). If you have a complaint about
the facility or person providing your services, you may contact the Office of Health Facility
Complaints, Minnesota Department of Health. You may also contact the Office of
Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health and
Developmental Disabilities."
new text end

new text begin (c) The statement must include contact information for the Minnesota Adult Abuse
Reporting Center and the telephone number, website address, e-mail address, mailing
address, and street address of the Office of Health Facility Complaints at the Minnesota
Department of Health, the Office of Ombudsman for Long-Term Care, and the Office of
Ombudsman for Mental Health and Developmental Disabilities. The statement must include
the facility's name, address, e-mail, telephone number, and name or title of the person at
the facility to whom problems or complaints may be directed. It must also include a statement
that the facility will not retaliate because of a complaint.
new text end

new text begin (d) A facility must obtain written acknowledgment of the resident's receipt of the assisted
living bill of rights or shall document why an acknowledgment cannot be obtained. The
acknowledgment may be obtained from the resident, legal representative, or designated
representative. Acknowledgment of receipt shall be retained in the resident's record.
new text end

new text begin Subd. 2. new text end

new text begin Notices in plain language; language accommodations. new text end

new text begin A facility must provide
all notices in plain language that residents can understand and make reasonable
accommodations for residents who have communication disabilities and those whose primary
language is a language other than English.
new text end

new text begin Subd. 3. new text end

new text begin Notice of dementia training. new text end

new text begin An assisted living facility with dementia care
shall make available in written or electronic form, to residents and families or other persons
who request it, a description of the training program and related training it provides, including
the categories of employees trained, the frequency of training, and the basic topics covered.
A hard copy of this notice must be provided upon request.
new text end

new text begin Subd. 4. new text end

new text begin Notice of available assistance. new text end

new text begin A facility shall provide each resident with
identifying and contact information about the persons who can assist with health care or
supportive services being provided. A facility shall keep each resident informed of changes
in the personnel referenced in this subdivision.
new text end

new text begin Subd. 5. new text end

new text begin Notice to residents; change in ownership or management. new text end

new text begin (a) A facility must
provide written notice to the resident, legal representative, or designated representative of
a change of ownership within seven calendar days after the facility receives a new license.
new text end

new text begin (b) A facility must provide prompt written notice to the resident and, as applicable, legal
representative or designated representative, of any change of legal name, telephone number,
and physical mailing address, which may not be a public or private post office box, of:
new text end

new text begin (1) the manager of the facility, if applicable; and
new text end

new text begin (2) the authorized agent.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 18.

new text begin [144I.16] SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Acceptance of residents. new text end

new text begin An assisted living facility may not accept a
person as a resident unless the facility has staff, sufficient in qualifications, competency,
and numbers, to adequately provide the services agreed to in the assisted living contract.
new text end

new text begin Subd. 2. new text end

new text begin Initial reviews, assessments, and monitoring. new text end

new text begin (a) Residents who are not
receiving any services shall not be required to undergo an initial nursing assessment.
new text end

new text begin (b) An assisted living facility shall conduct a nursing assessment by a registered nurse
of the physical and cognitive needs of the prospective resident and propose a temporary
service plan prior to the date on which a prospective resident executes a contract with a
facility or the date on which a prospective resident moves in, whichever is earlier. If
necessitated by either the geographic distance between the prospective resident and the
facility, or urgent or unexpected circumstances, the assessment may be conducted using
telecommunication methods based on practice standards that meet the resident's needs and
reflect person-centered planning and care delivery.
new text end

new text begin (c) Resident reassessment and monitoring must be conducted no more than 14 calendar
days after initiation of services. Ongoing resident reassessment and monitoring must be
conducted as needed based on changes in the needs of the resident and cannot exceed 90
calendar days from the last date of the assessment.
new text end

new text begin (d) For residents only receiving assisted living services specified in section 144I.01,
subdivision 9, clauses (1) to (5), the facility shall complete an individualized initial review
of the resident's needs and preferences. The initial review must be completed within 30
calendar days of the start of services. Resident monitoring and review must be conducted
as needed based on changes in the needs of the resident and cannot exceed 90 calendar days
from the date of the last review.
new text end

new text begin (e) A facility must inform the prospective resident of the availability of and contact
information for long-term care consultation services under section 256B.0911, prior to the
date on which a prospective resident executes a contract with a facility or the date on which
a prospective resident moves in, whichever is earlier.
new text end

new text begin Subd. 3. new text end

new text begin Temporary service plan. new text end

new text begin When a facility initiates services and the
individualized assessment required in subdivision 2 has not been completed, the facility
must complete a temporary plan and agreement with the resident for services. A temporary
service plan shall not be effective for more than 72 hours.
new text end

new text begin Subd. 4. new text end

new text begin Service plan, implementation, and revisions to service plan. new text end

new text begin (a) No later
than 14 calendar days after the date that services are first provided, an assisted living facility
shall finalize a current written service plan.
new text end

new text begin (b) The service plan and any revisions must include a signature or other authentication
by the facility and by the resident documenting agreement on the services to be provided.
The service plan must be revised, if needed, based on resident reassessment under subdivision
2. The facility must provide information to the resident about changes to the facility's fee
for services and how to contact the Office of Ombudsman for Long-Term Care.
new text end

new text begin (c) The facility must implement and provide all services required by the current service
plan.
new text end

new text begin (d) The service plan and the revised service plan must be entered into the resident record,
including notice of a change in a resident's fees when applicable.
new text end

new text begin (e) Staff providing services must be informed of the current written service plan.
new text end

new text begin (f) The service plan must include:
new text end

new text begin (1) a description of the services to be provided, the fees for services, and the frequency
of each service, according to the resident's current assessment and resident preferences;
new text end

new text begin (2) the identification of staff or categories of staff who will provide the services;
new text end

new text begin (3) the schedule and methods of monitoring assessments of the resident;
new text end

new text begin (4) the schedule and methods of monitoring staff providing services; and
new text end

new text begin (5) a contingency plan that includes:
new text end

new text begin (i) the action to be taken by the facility and by the resident and the designated
representative if the scheduled service cannot be provided;
new text end

new text begin (ii) information and a method for a resident to contact the facility;
new text end

new text begin (iii) the names and contact information of persons the resident wishes to have notified
in an emergency or if there is a significant adverse change in the resident's condition,
including identification of and information as to who has authority to sign for the resident
in an emergency; and
new text end

new text begin (iv) the circumstances in which emergency medical services are not to be summoned
consistent with chapters 145B and 145C, and declarations made by the resident under those
chapters.
new text end

new text begin Subd. 5. new text end

new text begin Referrals. new text end

new text begin If a facility reasonably believes that a resident is in need of another
medical or health service, including a licensed health professional, or social service provider,
the facility shall:
new text end

new text begin (1) determine the resident's preferences with respect to obtaining the service; and
new text end

new text begin (2) inform the resident of the resources available, if known, to assist the resident in
obtaining services.
new text end

new text begin Subd. 6. new text end

new text begin Medical cannabis. new text end

new text begin Assisted living facilities may exercise the authority and are
subject to the protections in section 152.34.
new text end

new text begin Subd. 7. new text end

new text begin Request for discontinuation of life-sustaining treatment. new text end

new text begin (a) If a resident,
family member, or other caregiver of the resident requests that an employee or other agent
of the facility discontinue a life-sustaining treatment, the employee or agent receiving the
request:
new text end

new text begin (1) shall take no action to discontinue the treatment; and
new text end

new text begin (2) shall promptly inform the supervisor or other agent of the facility of the resident's
request.
new text end

new text begin (b) Upon being informed of a request for discontinuance of treatment, the facility shall
promptly:
new text end

new text begin (1) inform the resident that the request will be made known to the physician or advanced
practice registered nurse who ordered the resident's treatment;
new text end

new text begin (2) inform the physician or advanced practice registered nurse of the resident's request;
and
new text end

new text begin (3) work with the resident and the resident's physician or advanced practice registered
nurse to comply with chapter 145C.
new text end

new text begin (c) This section does not require the facility to discontinue treatment, except as may be
required by law or court order.
new text end

new text begin (d) This section does not diminish the rights of residents to control their treatments,
refuse services, or terminate their relationships with the facility.
new text end

new text begin (e) This section shall be construed in a manner consistent with chapter 145B or 145C,
whichever applies, and declarations made by residents under those chapters.
new text end

new text begin Subd. 8. new text end

new text begin Applicability of other law. new text end

new text begin Assisted living facilities are subject to and must
comply with chapter 504B.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 19.

new text begin [144I.17] MEDICATION MANAGEMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Medication management services. new text end

new text begin (a) This section applies only to
assisted living facilities that provide medication management services.
new text end

new text begin (b) An assisted living facility that provides medication management services must
develop, implement, and maintain current written medication management policies and
procedures. The policies and procedures must be developed under the supervision and
direction of a registered nurse, licensed health professional, or pharmacist consistent with
current practice standards and guidelines.
new text end

new text begin (c) The written policies and procedures must address requesting and receiving
prescriptions for medications; preparing and giving medications; verifying that prescription
drugs are administered as prescribed; documenting medication management activities;
controlling and storing medications; monitoring and evaluating medication use; resolving
medication errors; communicating with the prescriber, pharmacist, and resident and legal
and designated representatives; disposing of unused medications; and educating residents
and legal and designated representatives about medications. When controlled substances
are being managed, the policies and procedures must also identify how the provider will
ensure security and accountability for the overall management, control, and disposition of
those substances in compliance with state and federal regulations and with subdivision 23.
new text end

new text begin Subd. 2. new text end

new text begin Provision of medication management services. new text end

new text begin (a) For each resident who
requests medication management services, the facility shall, prior to providing medication
management services, have a registered nurse, licensed health professional, or authorized
prescriber under section 151.37 conduct an assessment to determine what medication
management services will be provided and how the services will be provided. This assessment
must be conducted face-to-face with the resident. The assessment must include an
identification and review of all medications the resident is known to be taking. The review
and identification must include indications for medications, side effects, contraindications,
allergic or adverse reactions, and actions to address these issues.
new text end

new text begin (b) The assessment must identify interventions needed in management of medications
to prevent diversion of medication by the resident or others who may have access to the
medications and provide instructions to the resident and legal and designated representatives
on interventions to manage the resident's medications and prevent diversion of medications.
For purposes of this section, "diversion of medication" means misuse, theft, or illegal or
improper disposition of medications.
new text end

new text begin Subd. 3. new text end

new text begin Individualized medication monitoring and reassessment. new text end

new text begin The assisted living
facility must monitor and reassess the resident's medication management services as needed
under subdivision 2 when the resident presents with symptoms or other issues that may be
medication-related and, at a minimum, annually.
new text end

new text begin Subd. 4. new text end

new text begin Resident refusal. new text end

new text begin The assisted living facility must document in the resident's
record any refusal for an assessment for medication management by the resident. The facility
must discuss with the resident the possible consequences of the resident's refusal and
document the discussion in the resident's record.
new text end

new text begin Subd. 5. new text end

new text begin Individualized medication management plan. new text end

new text begin (a) For each resident receiving
medication management services, the assisted living facility must prepare and include in
the service plan a written statement of the medication management services that will be
provided to the resident. The facility must develop and maintain a current individualized
medication management record for each resident based on the resident's assessment that
must contain the following:
new text end

new text begin (1) a statement describing the medication management services that will be provided;
new text end

new text begin (2) a description of storage of medications based on the resident's needs and preferences,
risk of diversion, and consistent with the manufacturer's directions;
new text end

new text begin (3) documentation of specific resident instructions relating to the administration of
medications;
new text end

new text begin (4) identification of persons responsible for monitoring medication supplies and ensuring
that medication refills are ordered on a timely basis;
new text end

new text begin (5) identification of medication management tasks that may be delegated to unlicensed
personnel;
new text end

new text begin (6) procedures for staff notifying a registered nurse or appropriate licensed health
professional when a problem arises with medication management services; and
new text end

new text begin (7) any resident-specific requirements relating to documenting medication administration,
verifications that all medications are administered as prescribed, and monitoring of
medication use to prevent possible complications or adverse reactions.
new text end

new text begin (b) The medication management record must be current and updated when there are any
changes.
new text end

new text begin (c) Medication reconciliation must be completed when a licensed nurse, licensed health
professional, or authorized prescriber is providing medication management.
new text end

new text begin Subd. 6. new text end

new text begin Administration of medication. new text end

new text begin Medications may be administered by a nurse,
physician, or other licensed health practitioner authorized to administer medications or by
unlicensed personnel who have been delegated medication administration tasks by a
registered nurse.
new text end

new text begin Subd. 7. new text end

new text begin Delegation of medication administration. new text end

new text begin When administration of medications
is delegated to unlicensed personnel, the assisted living facility must ensure that the registered
nurse has:
new text end

new text begin (1) instructed the unlicensed personnel in the proper methods to administer the
medications, and the unlicensed personnel has demonstrated the ability to competently
follow the procedures;
new text end

new text begin (2) specified, in writing, specific instructions for each resident and documented those
instructions in the resident's records; and
new text end

new text begin (3) communicated with the unlicensed personnel about the individual needs of the
resident.
new text end

new text begin Subd. 8. new text end

new text begin Documentation of administration of medications. new text end

new text begin Each medication
administered by the assisted living facility staff must be documented in the resident's record.
The documentation must include the signature and title of the person who administered the
medication. The documentation must include the medication name, dosage, date and time
administered, and method and route of administration. The staff must document the reason
why medication administration was not completed as prescribed and document any follow-up
procedures that were provided to meet the resident's needs when medication was not
administered as prescribed and in compliance with the resident's medication management
plan.
new text end

new text begin Subd. 9. new text end

new text begin Documentation of medication setup. new text end

new text begin Documentation of dates of medication
setup, name of medication, quantity of dose, times to be administered, route of administration,
and name of person completing medication setup must be done at the time of setup.
new text end

new text begin Subd. 10. new text end

new text begin Medication management for residents who will be away from home. new text end

new text begin (a)
An assisted living facility that is providing medication management services to the resident
must develop and implement policies and procedures for giving accurate and current
medications to residents for planned or unplanned times away from home according to the
resident's individualized medication management plan. The policies and procedures must
state that:
new text end

new text begin (1) for planned time away, the medications must be obtained from the pharmacy or set
up by the licensed nurse according to appropriate state and federal laws and nursing standards
of practice;
new text end

new text begin (2) for unplanned time away, when the pharmacy is not able to provide the medications,
a licensed nurse or unlicensed personnel shall give the resident or a legal representative
medications in amounts and dosages needed for the length of the anticipated absence, not
to exceed seven calendar days;
new text end

new text begin (3) the resident and a legal or designated representative must be provided written
information on medications, including any special instructions for administering or handling
the medications, including controlled substances;
new text end

new text begin (4) the medications must be placed in a medication container or containers appropriate
to the provider's medication system and must be labeled with the resident's name and the
dates and times that the medications are scheduled; and
new text end

new text begin (5) the resident and legal and designated representative must be provided in writing the
facility's name and information on how to contact the facility.
new text end

new text begin (b) For unplanned time away when the licensed nurse is not available, the registered
nurse may delegate this task to unlicensed personnel if:
new text end

new text begin (1) the registered nurse has trained the unlicensed staff and determined the unlicensed
staff is competent to follow the procedures for giving medications to residents; and
new text end

new text begin (2) the registered nurse has developed written procedures for the unlicensed personnel,
including any special instructions or procedures regarding controlled substances that are
prescribed for the resident. The procedures must address:
new text end

new text begin (i) the type of container or containers to be used for the medications appropriate to the
provider's medication system;
new text end

new text begin (ii) how the container or containers must be labeled;
new text end

new text begin (iii) written information about the medications to be given to the resident or designated
representative;
new text end

new text begin (iv) how the unlicensed staff must document in the resident's record that medications
have been given to the resident and the designated representative, including documenting
the date the medications were given to the resident or the designated representative and who
received the medications, the person who gave the medications to the resident, the number
of medications that were given to the resident, and other required information;
new text end

new text begin (v) how the registered nurse shall be notified that medications have been given to the
resident or designated representative and whether the registered nurse needs to be contacted
before the medications are given to the resident or the designated representative;
new text end

new text begin (vi) a review by the registered nurse of the completion of this task to verify that this task
was completed accurately by the unlicensed personnel; and
new text end

new text begin (vii) how the unlicensed personnel must document in the resident's record any unused
medications that are returned to the facility, including the name of each medication and the
doses of each returned medication.
new text end

new text begin Subd. 11. new text end

new text begin Prescribed and nonprescribed medication. new text end

new text begin The assisted living facility must
determine whether the facility shall require a prescription for all medications the provider
manages. The facility must inform the resident and the legal and designated representatives
whether the facility requires a prescription for all over-the-counter and dietary supplements
before the facility agrees to manage those medications.
new text end

new text begin Subd. 12. new text end

new text begin Medications; over-the-counter drugs; dietary supplements not
prescribed. new text end

new text begin An assisted living facility providing medication management services for
over-the-counter drugs or dietary supplements must retain those items in the original labeled
container with directions for use prior to setting up for immediate or later administration.
The facility must verify that the medications are up to date and stored as appropriate.
new text end

new text begin Subd. 13. new text end

new text begin Prescriptions. new text end

new text begin There must be a current written or electronically recorded
prescription as defined in section 151.01, subdivision 16a, for all prescribed medications
that the assisted living facility is managing for the resident.
new text end

new text begin Subd. 14. new text end

new text begin Renewal of prescriptions. new text end

new text begin Prescriptions must be renewed at least every 12
months or more frequently as indicated by the assessment in subdivision 2. Prescriptions
for controlled substances must comply with chapter 152.
new text end

new text begin Subd. 15. new text end

new text begin Verbal prescription orders. new text end

new text begin Verbal prescription orders from an authorized
prescriber must be received by a nurse or pharmacist. The order must be handled according
to Minnesota Rules, part 6800.6200.
new text end

new text begin Subd. 16. new text end

new text begin Written or electronic prescription. new text end

new text begin When a written or electronic prescription
is received, it must be communicated to the registered nurse in charge and recorded or placed
in the resident's record.
new text end

new text begin Subd. 17. new text end

new text begin Records confidential. new text end

new text begin A prescription or order received verbally, in writing,
or electronically must be kept confidential according to sections 144.291 to 144.298 and
144A.44.
new text end

new text begin Subd. 18. new text end

new text begin Medications provided by resident or family members. new text end

new text begin When the assisted
living facility is aware of any medications or dietary supplements that are being used by
the resident and are not included in the assessment for medication management services,
the staff must advise the registered nurse and document that in the resident record.
new text end

new text begin Subd. 19. new text end

new text begin Storage of medications. new text end

new text begin An assisted living facility must store all prescription
medications in securely locked and substantially constructed compartments according to
the manufacturer's directions and permit only authorized personnel to have access.
new text end

new text begin Subd. 20. new text end

new text begin Prescription drugs. new text end

new text begin A prescription drug, prior to being set up for immediate
or later administration, must be kept in the original container in which it was dispensed by
the pharmacy bearing the original prescription label with legible information including the
expiration or beyond-use date of a time-dated drug.
new text end

new text begin Subd. 21. new text end

new text begin Prohibitions. new text end

new text begin No prescription drug supply for one resident may be used or
saved for use by anyone other than the resident.
new text end

new text begin Subd. 22. new text end

new text begin Disposition of medications. new text end

new text begin (a) Any current medications being managed by
the assisted living facility must be given to the resident or the designated representative
when the resident's service plan ends or medication management services are no longer part
of the service plan. Medications for a resident who is deceased or that have been discontinued
or have expired may be given to the resident or the designated representative for disposal.
new text end

new text begin (b) The facility shall dispose of any medications remaining with the facility that are
discontinued or expired or upon the termination of the service contract or the resident's
death according to state and federal regulations for disposition of medications and controlled
substances.
new text end

new text begin (c) Upon disposition, the facility must document in the resident's record the disposition
of the medication including the medication's name, strength, prescription number as
applicable, quantity, to whom the medications were given, date of disposition, and names
of staff and other individuals involved in the disposition.
new text end

new text begin Subd. 23. new text end

new text begin Loss or spillage. new text end

new text begin (a) Assisted living facilities providing medication
management must develop and implement procedures for loss or spillage of all controlled
substances defined in Minnesota Rules, part 6800.4220. These procedures must require that
when a spillage of a controlled substance occurs, a notation must be made in the resident's
record explaining the spillage and the actions taken. The notation must be signed by the
person responsible for the spillage and include verification that any contaminated substance
was disposed of according to state or federal regulations.
new text end

new text begin (b) The procedures must require that the facility providing medication management
investigate any known loss or unaccounted for prescription drugs and take appropriate action
required under state or federal regulations and document the investigation in required records.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 20.

new text begin [144I.18] TREATMENT AND THERAPY MANAGEMENT SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Treatment and therapy management services. new text end

new text begin This section applies
only to assisted living facilities that provide treatment and therapy management services.
new text end

new text begin Subd. 2. new text end

new text begin Policies and procedures. new text end

new text begin (a) An assisted living facility that provides treatment
and therapy management services must develop, implement, and maintain up-to-date written
treatment or therapy management policies and procedures. The policies and procedures
must be developed under the supervision and direction of a registered nurse or appropriate
licensed health professional consistent with current practice standards and guidelines.
new text end

new text begin (b) The written policies and procedures must address requesting and receiving orders
or prescriptions for treatments or therapies, providing the treatment or therapy, documenting
treatment or therapy activities, educating and communicating with residents about treatments
or therapies they are receiving, monitoring and evaluating the treatment or therapy, and
communicating with the prescriber.
new text end

new text begin Subd. 3. new text end

new text begin Individualized treatment or therapy management plan. new text end

new text begin For each resident
receiving management of ordered or prescribed treatments or therapy services, the assisted
living facility must prepare and include in the service plan a written statement of the treatment
or therapy services that will be provided to the resident. The facility must also develop and
maintain a current individualized treatment and therapy management record for each resident
which must contain at least the following:
new text end

new text begin (1) a statement of the type of services that will be provided;
new text end

new text begin (2) documentation of specific resident instructions relating to the treatments or therapy
administration;
new text end

new text begin (3) identification of treatment or therapy tasks that will be delegated to unlicensed
personnel;
new text end

new text begin (4) procedures for notifying a registered nurse or appropriate licensed health professional
when a problem arises with treatments or therapy services; and
new text end

new text begin (5) any resident-specific requirements relating to documentation of treatment and therapy
received, verification that all treatment and therapy was administered as prescribed, and
monitoring of treatment or therapy to prevent possible complications or adverse reactions.
The treatment or therapy management record must be current and updated when there are
any changes.
new text end

new text begin Subd. 4. new text end

new text begin Administration of treatments and therapy. new text end

new text begin Ordered or prescribed treatments
or therapies must be administered by a nurse, physician, or other licensed health professional
authorized to perform the treatment or therapy, or may be delegated or assigned to unlicensed
personnel by the licensed health professional according to the appropriate practice standards
for delegation or assignment. When administration of a treatment or therapy is delegated
or assigned to unlicensed personnel, the facility must ensure that the registered nurse or
authorized licensed health professional has:
new text end

new text begin (1) instructed the unlicensed personnel in the proper methods with respect to each resident
and the unlicensed personnel has demonstrated the ability to competently follow the
procedures;
new text end

new text begin (2) specified, in writing, specific instructions for each resident and documented those
instructions in the resident's record; and
new text end

new text begin (3) communicated with the unlicensed personnel about the individual needs of the
resident.
new text end

new text begin Subd. 5. new text end

new text begin Documentation of administration of treatments and therapies. new text end

new text begin Each treatment
or therapy administered by an assisted living facility must be in the resident record. The
documentation must include the signature and title of the person who administered the
treatment or therapy and must include the date and time of administration. When treatment
or therapies are not administered as ordered or prescribed, the provider must document the
reason why it was not administered and any follow-up procedures that were provided to
meet the resident's needs.
new text end

new text begin Subd. 6. new text end

new text begin Treatment and therapy orders. new text end

new text begin There must be an up-to-date written or
electronically recorded order from an authorized prescriber for all treatments and therapies.
The order must contain the name of the resident, a description of the treatment or therapy
to be provided, and the frequency, duration, and other information needed to administer the
treatment or therapy. Treatment and therapy orders must be renewed at least every 12
months.
new text end

new text begin Subd. 7. new text end

new text begin Right to outside service provider; other payors. new text end

new text begin Under section 144I.101, a
resident is free to retain therapy and treatment services from an off-site service provider.
Assisted living facilities must make every effort to assist residents in obtaining information
regarding whether the Medicare program, the medical assistance program under chapter
256B, or another public program will pay for any or all of the services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 21.

new text begin [144I.19] RESIDENT RECORD REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Resident record. new text end

new text begin (a) Assisted living facilities must maintain records for
each resident for whom it is providing services. Entries in the resident records must be
current, legible, permanently recorded, dated, and authenticated with the name and title of
the person making the entry.
new text end

new text begin (b) Resident records, whether written or electronic, must be protected against loss,
tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable
relevant federal and state laws. The facility shall establish and implement written procedures
to control use, storage, and security of resident records and establish criteria for release of
resident information.
new text end

new text begin (c) The facility may not disclose to any other person any personal, financial, or medical
information about the resident, except:
new text end

new text begin (1) as may be required by law;
new text end

new text begin (2) to employees or contractors of the facility, another facility, other health care
practitioner or provider, or inpatient facility needing information in order to provide services
to the resident, but only the information that is necessary for the provision of services;
new text end

new text begin (3) to persons authorized in writing by the resident or the legal representative to receive
the information, including third-party payers; and
new text end

new text begin (4) to representatives of the commissioner authorized to survey or investigate facilities
under this chapter or federal laws.
new text end

new text begin Subd. 2. new text end

new text begin Access to records. new text end

new text begin The facility must ensure that the appropriate records are
readily available to employees and contractors authorized to access the records. Resident
records must be maintained in a manner that allows for timely access, printing, or
transmission of the records. The records must be made readily available to the commissioner
upon request.
new text end

new text begin Subd. 3. new text end

new text begin Contents of resident record. new text end

new text begin Contents of a resident record include the following
for each resident:
new text end

new text begin (1) identifying information, including the resident's name, date of birth, address, and
telephone number;
new text end

new text begin (2) the name, address, and telephone number of an emergency contact, family members,
designated representative, if any, legal representative, if any, or others as identified;
new text end

new text begin (3) names, addresses, and telephone numbers of the resident's health and medical service
providers, if known;
new text end

new text begin (4) health information, including medical history, allergies, and when the provider is
managing medications, treatments or therapies that require documentation, and other relevant
health records;
new text end

new text begin (5) the resident's advance directives, if any;
new text end

new text begin (6) copies of any health care directives, guardianships, powers of attorney, or
conservatorships;
new text end

new text begin (7) the facility's current and previous assessments and service plans;
new text end

new text begin (8) all records of communications pertinent to the resident's services;
new text end

new text begin (9) documentation of significant changes in the resident's status and actions taken in
response to the needs of the resident, including reporting to the appropriate supervisor or
health care professional;
new text end

new text begin (10) documentation of incidents involving the resident and actions taken in response to
the needs of the resident, including reporting to the appropriate supervisor or health care
professional;
new text end

new text begin (11) documentation that services have been provided as identified in the service plan;
new text end

new text begin (12) documentation that the resident has received and reviewed the assisted living bill
of rights;
new text end

new text begin (13) documentation of complaints received and any resolution;
new text end

new text begin (14) a discharge summary, including service termination notice and related
documentation, when applicable; and
new text end

new text begin (15) other documentation required under this chapter and relevant to the resident's
services or status.
new text end

new text begin Subd. 4. new text end

new text begin Transfer of resident records. new text end

new text begin With the resident's knowledge and consent, if
a resident is relocated to another facility or to a nursing home, or if care is transferred to
another service provider, the facility must timely convey to the new facility, nursing home,
or provider:
new text end

new text begin (1) the resident's full name, date of birth, and insurance information;
new text end

new text begin (2) the name, telephone number, and address of the resident's designated representatives
and legal representatives, if any;
new text end

new text begin (3) the resident's current documented diagnoses that are relevant to the services being
provided;
new text end

new text begin (4) the resident's known allergies that are relevant to the services being provided;
new text end

new text begin (5) the name and telephone number of the resident's physician, if known, and the current
physician orders that are relevant to the services being provided;
new text end

new text begin (6) all medication administration records that are relevant to the services being provided;
new text end

new text begin (7) the most recent resident assessment, if relevant to the services being provided; and
new text end

new text begin (8) copies of health care directives, "do not resuscitate" orders, and any guardianship
orders or powers of attorney.
new text end

new text begin Subd. 5. new text end

new text begin Record retention. new text end

new text begin Following the resident's discharge or termination of services,
an assisted living facility must retain a resident's record for at least five years or as otherwise
required by state or federal regulations. Arrangements must be made for secure storage and
retrieval of resident records if the facility ceases to operate.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 22.

new text begin [144I.20] ORIENTATION AND ANNUAL TRAINING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Orientation of staff and supervisors. new text end

new text begin All staff providing and supervising
direct services must complete an orientation to assisted living facility licensing requirements
and regulations before providing assisted living services to residents. The orientation may
be incorporated into the training required under subdivision 6. The orientation need only
be completed once for each staff person and is not transferable to another facility.
new text end

new text begin Subd. 2. new text end

new text begin Content. new text end

new text begin (a) The orientation must contain the following topics:
new text end

new text begin (1) an overview of this chapter;
new text end

new text begin (2) an introduction and review of the facility's policies and procedures related to the
provision of assisted living services by the individual staff person;
new text end

new text begin (3) handling of emergencies and use of emergency services;
new text end

new text begin (4) compliance with and reporting of the maltreatment of vulnerable adults under section
626.557 to the Minnesota Adult Abuse Reporting Center (MAARC);
new text end

new text begin (5) the assisted living bill of rights and staff responsibilities related to ensuring the
exercise and protection of those rights;
new text end

new text begin (6) the principles of person-centered planning and service delivery and how they apply
to direct support services provided by the staff person;
new text end

new text begin (7) handling of residents' complaints, reporting of complaints, and where to report
complaints, including information on the Office of Health Facility Complaints;
new text end

new text begin (8) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
Ombudsman at the Department of Human Services, county-managed care advocates, or
other relevant advocacy services; and
new text end

new text begin (9) a review of the types of assisted living services the employee will be providing and
the facility's category of licensure.
new text end

new text begin (b) In addition to the topics in paragraph (a), orientation may also contain training on
providing services to residents with hearing loss. Any training on hearing loss provided
under this subdivision must be high quality and research based, may include online training,
and must include training on one or more of the following topics:
new text end

new text begin (1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
and the challenges it poses to communication;
new text end

new text begin (2) health impacts related to untreated age-related hearing loss, such as increased
incidence of dementia, falls, hospitalizations, isolation, and depression; or
new text end

new text begin (3) information about strategies and technology that may enhance communication and
involvement, including communication strategies, assistive listening devices, hearing aids,
visual and tactile alerting devices, communication access in real time, and closed captions.
new text end

new text begin Subd. 3. new text end

new text begin Verification and documentation of orientation and training. new text end

new text begin The assisted
living facility shall retain evidence in the employee record of each staff person having
completed the orientation and training required by this section.
new text end

new text begin Subd. 4. new text end

new text begin Orientation to resident. new text end

new text begin Staff providing assisted living services must be oriented
specifically to each individual resident and the services to be provided. This orientation
may be provided in person, orally, in writing, or electronically.
new text end

new text begin Subd. 5. new text end

new text begin Training required relating to dementia. new text end

new text begin All direct care staff and supervisors
providing direct services must demonstrate an understanding of the training specified in
section 144I.21.
new text end

new text begin Subd. 6. new text end

new text begin Required annual training. new text end

new text begin (a) All staff that perform direct services must
complete at least eight hours of annual training for each 12 months of employment. The
training may be obtained from the facility or another source and must include topics relevant
to the provision of assisted living services. The annual training must include:
new text end

new text begin (1) training on reporting of maltreatment of vulnerable adults under section 626.557;
new text end

new text begin (2) review of the assisted living bill of rights and staff responsibilities related to ensuring
the exercise and protection of those rights;
new text end

new text begin (3) review of infection control techniques used in the home and implementation of
infection control standards including a review of hand washing techniques; the need for and
use of protective gloves, gowns, and masks; appropriate disposal of contaminated materials
and equipment, such as dressings, needles, syringes, and razor blades; disinfecting reusable
equipment; disinfecting environmental surfaces; and reporting communicable diseases;
new text end

new text begin (4) effective approaches to use to problem solve when working with a resident's
challenging behaviors, and how to communicate with residents who have dementia,
Alzheimer's disease, or related disorders;
new text end

new text begin (5) review of the facility's policies and procedures relating to the provision of assisted
living services and how to implement those policies and procedures; and
new text end

new text begin (6) the principles of person-centered planning and service delivery and how they apply
to direct support services provided by the staff person.
new text end

new text begin (b) In addition to the topics in paragraph (a), annual training may also contain training
on providing services to residents with hearing loss. Any training on hearing loss provided
under this subdivision must be high quality and research based, may include online training,
and must include training on one or more of the following topics:
new text end

new text begin (1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
and challenges it poses to communication;
new text end

new text begin (2) the health impacts related to untreated age-related hearing loss, such as increased
incidence of dementia, falls, hospitalizations, isolation, and depression; or
new text end

new text begin (3) information about strategies and technology that may enhance communication and
involvement, including communication strategies, assistive listening devices, hearing aids,
visual and tactile alerting devices, communication access in real time, and closed captions.
new text end

new text begin Subd. 7. new text end

new text begin Implementation. new text end

new text begin The assisted living facility must implement all orientation
and training topics covered in this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 23.

new text begin [144I.21] TRAINING IN DEMENTIA CARE REQUIRED.
new text end

new text begin (a) All assisted living facilities must meet the following training requirements:
new text end

new text begin (1) supervisors of direct-care staff must have at least eight hours of initial training on
topics specified under paragraph (b) within 120 working hours of the employment start
date, and must have at least two hours of training on topics related to dementia care for each
12 months of employment thereafter;
new text end

new text begin (2) direct-care employees must have completed at least eight hours of initial training on
topics specified under paragraph (b) within 160 working hours of the employment start
date. Until this initial training is complete, an employee must not provide direct care unless
there is another employee on site who has completed the initial eight hours of training on
topics related to dementia care and who can act as a resource and assist if issues arise. A
trainer of the requirements under paragraph (b) or a supervisor meeting the requirements
in clause (1) must be available for consultation with the new employee until the training
requirement is complete. Direct-care employees must have at least two hours of training on
topics related to dementia for each 12 months of employment thereafter;
new text end

new text begin (3) for assisted living facilities with dementia care, direct care employees must have
completed at least eight hours of initial training on topics specified under paragraph (b)
within 80 working hours of the employment start date. Until this initial training is complete,
an employee must not provide direct care unless there is another employee on site who has
completed the initial eight hours of training on topics related to dementia care and who can
act as a resource and assist if issues arise. A trainer of the requirements under paragraph
(b) or a supervisor meeting the requirements in clause (1) must be available for consultation
with the new employee until the training requirement is complete. Direct-care employees
must have at least two hours of training on topics related to dementia for each 12 months
of employment thereafter;
new text end

new text begin (4) staff who do not provide direct care, including maintenance, housekeeping, and food
service staff, must have at least four hours of initial training on topics specified under
paragraph (b) within 160 working hours of the employment start date, and must have at
least two hours of training on topics related to dementia care for each 12 months of
employment thereafter; and
new text end

new text begin (5) new employees may satisfy the initial training requirements by producing written
proof of previously completed required training within the past 18 months.
new text end

new text begin (b) Areas of required training include:
new text end

new text begin (1) an explanation of Alzheimer's disease and other dementias;
new text end

new text begin (2) assistance with activities of daily living;
new text end

new text begin (3) problem solving with challenging behaviors;
new text end

new text begin (4) communication skills; and
new text end

new text begin (5) person-centered planning and service delivery.
new text end

new text begin (c) The facility shall provide to consumers in written or electronic form a description of
the training program, the categories of employees trained, the frequency of training, and
the basic topics covered.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 24.

new text begin [144I.22] CONTROLLING INDIVIDUAL RESTRICTIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Restrictions. new text end

new text begin (a) The commissioner has discretion to bar any controlling
individual of a facility if the person was a controlling individual of any other nursing home
or assisted living facility in the previous two-year period and:
new text end

new text begin (1) during that period of time the nursing home or assisted living facility incurred the
following number of uncorrected or repeated violations:
new text end

new text begin (i) two or more repeated violations that created an imminent risk to direct resident care
or safety; or
new text end

new text begin (ii) four or more uncorrected violations that created an imminent risk to direct resident
care or safety; or
new text end

new text begin (2) during that period of time, was convicted of a felony or gross misdemeanor that
related to the operation of the nursing home or assisted living facility, or directly affected
resident safety or care.
new text end

new text begin (b) When the commissioner bars a controlling individual under this subdivision, the
controlling individual may appeal the commissioner's decision under chapter 14.
new text end

new text begin Subd. 2. new text end

new text begin Exception. new text end

new text begin Subdivision 1 does not apply to any controlling individual of the
facility who had no legal authority to affect or change decisions related to the operation of
the nursing home or assisted living facility that incurred the uncorrected violations.
new text end

new text begin Subd. 3. new text end

new text begin Stay of adverse action required by controlling individual restrictions. new text end

new text begin (a)
In lieu of revoking, suspending, or refusing to renew the license of a facility where a
controlling individual was disqualified by subdivision 1, paragraph (a), clause (1), the
commissioner may issue an order staying the revocation, suspension, or nonrenewal of the
facility's license. The order may but need not be contingent upon the facility's compliance
with restrictions and conditions imposed on the license to ensure the proper operation of
the facility and to protect the health, safety, comfort, treatment, and well-being of the
residents in the facility. The decision to issue an order for a stay must be made within 90
calendar days of the commissioner's determination that a controlling individual of the facility
is disqualified by subdivision 1, paragraph (a), clause (1), from operating a facility.
new text end

new text begin (b) In determining whether to issue a stay and to impose conditions and restrictions, the
commissioner must consider the following factors:
new text end

new text begin (1) the ability of the controlling individual to operate other facilities in accordance with
the licensure rules and laws;
new text end

new text begin (2) the conditions in the nursing home or assisted living facility that received the number
and type of uncorrected or repeated violations described in subdivision 1, paragraph (a),
clause (1); and
new text end

new text begin (3) the conditions and compliance history of each of the nursing homes and assisted
living facilities owned or operated by the controlling individual.
new text end

new text begin (c) The commissioner's decision to exercise the authority under this subdivision in lieu
of revoking, suspending, or refusing to renew the license of the facility is not subject to
administrative or judicial review.
new text end

new text begin (d) The order for the stay of revocation, suspension, or nonrenewal of the facility license
must include any conditions and restrictions on the license that the commissioner deems
necessary based on the factors listed in paragraph (b).
new text end

new text begin (e) Prior to issuing an order for stay of revocation, suspension, or nonrenewal, the
commissioner shall inform the licensee and the controlling individual in writing of any
conditions and restrictions that will be imposed. The controlling individual shall, within ten
working days, notify the commissioner in writing of a decision to accept or reject the
conditions and restrictions. If any of the conditions or restrictions are rejected, the
commissioner must either modify the conditions and restrictions or take action to suspend,
revoke, or not renew the facility's license.
new text end

new text begin (f) Upon issuance of the order for a stay of revocation, suspension, or nonrenewal, the
controlling individual shall be responsible for compliance with the conditions and restrictions.
Any time after the conditions and restrictions have been in place for 180 days, the controlling
individual may petition the commissioner for removal or modification of the conditions and
restrictions. The commissioner must respond to the petition within 30 days of receipt of the
written petition. If the commissioner denies the petition, the controlling individual may
request a hearing under chapter 14. Any hearing shall be limited to a determination of
whether the conditions and restrictions shall be modified or removed. At the hearing, the
controlling individual bears the burden of proof.
new text end

new text begin (g) The failure of the controlling individual to comply with the conditions and restrictions
contained in the order for stay shall result in the immediate removal of the stay and the
commissioner shall take action to suspend, revoke, or not renew the license.
new text end

new text begin (h) The conditions and restrictions are effective for two years after the date they are
imposed.
new text end

new text begin (i) Nothing in this subdivision shall be construed to limit in any way the commissioner's
ability to impose other sanctions against a licensee under the standards in state or federal
law whether or not a stay of revocation, suspension, or nonrenewal is issued.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 25.

new text begin [144I.24] MINIMUM SITE, PHYSICAL ENVIRONMENT, AND FIRE
SAFETY REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Requirements. new text end

new text begin (a) The following are required for all assisted living
facilities:
new text end

new text begin (1) public utilities must be available, and working or inspected and approved water and
septic systems must be in place;
new text end

new text begin (2) the location must be publicly accessible to fire department services and emergency
medical services;
new text end

new text begin (3) the location's topography must provide sufficient natural drainage and is not subject
to flooding;
new text end

new text begin (4) all-weather roads and walks must be provided within the lot lines to the primary
entrance and the service entrance, including employees' and visitors' parking at the site; and
new text end

new text begin (5) the location must include space for outdoor activities for residents.
new text end

new text begin (b) An assisted living facility with dementia care that has a secured dementia care unit
must also meet the following requirements:
new text end

new text begin (1) a hazard vulnerability assessment or safety risk must be performed on and around
the property. The hazards indicated on the assessment must be assessed and mitigated to
protect the residents from harm; and
new text end

new text begin (2) the facility shall be protected throughout by an approved supervised automatic
sprinkler system by August 1, 2029.
new text end

new text begin Subd. 2. new text end

new text begin Fire protection and physical environment. new text end

new text begin (a) Each assisted living facility
must have a comprehensive fire protection system that includes:
new text end

new text begin (1) protection throughout by an approved supervised automatic sprinkler system according
to building code requirements established in Minnesota Rules, part 1305.0903, or smoke
detectors in each occupied room installed and maintained in accordance with the National
Fire Protection Association (NFPA) Standard 72;
new text end

new text begin (2) portable fire extinguishers installed and tested in accordance with the NFPA Standard
10; and
new text end

new text begin (3) the physical environment, including walls, floors, ceiling, all furnishings, grounds,
systems, and equipment that is kept in a continuous state of good repair and operation with
regard to the health, safety, comfort, and well-being of the residents in accordance with a
maintenance and repair program.
new text end

new text begin (b) Fire drills in assisted living facilities shall be conducted in accordance with the
residential board and care requirements in the Life Safety Code, except that fire drills in
secured dementia care units shall be conducted in accordance with the healthcare (limited
care) chapter of the Life Safety Code.
new text end

new text begin (c) Existing construction or elements, including assisted living facilities that were
registered as housing with services establishments under chapter 144D prior to August 1,
2021, shall be permitted to be continued in use provided such use does not constitute a
distinct hazard to life. Any existing elements that an authority having jurisdiction deems a
distinct hazard to life must be corrected. The facility must document in the facility's records
any actions taken to comply with a correction order, and must submit to the commissioner
for review and approval prior to correction.
new text end

new text begin Subd. 3. new text end

new text begin Local laws apply. new text end

new text begin Assisted living facilities shall comply with all applicable
state and local governing laws, regulations, standards, ordinances, and codes for fire safety,
building, and zoning requirements.
new text end

new text begin Subd. 4. new text end

new text begin Design requirements. new text end

new text begin (a) All assisted living facilities with six or more residents
must meet the provisions relevant to assisted living facilities in the most current edition of
the Facility Guidelines Institute "Guidelines for Design and Construction of Residential
Health, Care and Support Facilities" and of adopted rules. This minimum design standard
must be met for all new licenses, new construction, modifications, renovations, alterations,
changes of use, or additions. In addition to the guidelines, assisted living facilities shall
provide the option of a bath in addition to a shower for all residents.
new text end

new text begin (b) If the commissioner decides to update the edition of the guidelines specified in
paragraph (a) for purposes of this subdivision, the commissioner must notify the chairs and
ranking minority members of the legislative committees and divisions with jurisdiction over
health care and public safety of the planned update by January 15 of the year in which the
new edition will become effective. Following notice from the commissioner, the new edition
shall become effective for assisted living facilities beginning August 1 of that year, unless
provided otherwise in law. The commissioner shall, by publication in the State Register,
specify a date by which facilities must comply with the updated edition. The date by which
facilities must comply shall not be sooner than six months after publication of the
commissioner's notice in the State Register.
new text end

new text begin Subd. 5. new text end

new text begin Assisted living facilities; life safety code. new text end

new text begin (a) All assisted living facilities with
six or more residents must meet the applicable provisions of the most current edition of the
NFPA Standard 101, Life Safety Code, Residential Board and Care Occupancies chapter.
The minimum design standard shall be met for all new licenses, new construction,
modifications, renovations, alterations, changes of use, or additions.
new text end

new text begin (b) If the commissioner decides to update the Life Safety Code for purposes of this
subdivision, the commissioner must notify the chairs and ranking minority members of the
legislative committees and divisions with jurisdiction over health care and public safety of
the planned update by January 15 of the year in which the new Life Safety Code will become
effective. Following notice from the commissioner, the new edition shall become effective
for assisted living facilities beginning August 1 of that year, unless provided otherwise in
law. The commissioner shall, by publication in the State Register, specify a date by which
facilities must comply with the updated Life Safety Code. The date by which facilities must
comply shall not be sooner than six months after publication of the commissioner's notice
in the State Register.
new text end

new text begin Subd. 6. new text end

new text begin Assisted living facilities with dementia care and secured dementia care
unit; Life Safety Code. new text end

new text begin (a) All assisted living facilities with dementia care and a secured
dementia care unit must meet the applicable provisions of the most current edition of the
NFPA Standard 101, Life Safety Code, Healthcare (limited care) chapter. The minimum
design standards shall be met for all new licenses, new construction, modifications,
renovations, alterations, changes of use, or additions.
new text end

new text begin (b) If the commissioner decides to update the Life Safety Code for purposes of this
subdivision, the commissioner must notify the chairs and ranking minority members of the
legislative committees and divisions with jurisdiction over health care and public safety of
the planned update by January 15 of the year in which the new Life Safety Code will become
effective. Following notice from the commissioner, the new edition shall become effective
for assisted living facilities with dementia care and a secured dementia care unit beginning
August 1 of that year, unless provided otherwise in law. The commissioner shall, by
publication in the State Register, specify a date by which these facilities must comply with
the updated Life Safety Code. The date by which these facilities must comply shall not be
sooner than six months after publication of the commissioner's notice in the State Register.
new text end

new text begin Subd. 7. new text end

new text begin New construction; plans. new text end

new text begin (a) For all new licensure and construction beginning
on or after August 1, 2021, the following must be provided to the commissioner:
new text end

new text begin (1) architectural and engineering plans and specifications for new construction must be
prepared and signed by architects and engineers who are registered in Minnesota. Final
working drawings and specifications for proposed construction must be submitted to the
commissioner for review and approval;
new text end

new text begin (2) final architectural plans and specifications must include elevations and sections
through the building showing types of construction, and must indicate dimensions and
assignments of rooms and areas, room finishes, door types and hardware, elevations and
</